Icd 10 code for lumbar disc herniation with radiculopathy

Lumbar radiculopathy is commonly associated with other lower spinal pathologies due to ICD 10 coding guidelines for disc prolapse with radiculopathy, stenosis, traumatic injuries, etc. So, Lumbar radiculopathy should always be coded accordingly. 

ICD 10 CM Coding For Lumbar Radiculopathies

Radiculopathies fall in the M54 category of the ICD 10 CM book.

Whenever you code for radiculopathies, always take care of “excludes 1” criteria. A few Diagnosis codes can never be used simultaneously as the code above Excludes 1 note.

Unspecified Code (Lumbar Radiculopathy)

When radiculopathy is not specified or associated causes or conditions are not mentioned in medical reports, always go with the unspecified code M54.10.

Laterality Specific Code (Lumbar Radiculopathy)

Lumbar radiculopathy usually occurs in the L1-L5 lumbar region and L5-S1 lumbosacral region (most common). From these regions, spinal nerve roots originate and run downward in either extremity on which basis we code as left or right, laterality specific conditions. 

For right lumbar radiculopathy ICD 10, we use: 

• ICD 10 M54.41 – Lumbago with sciatica, right side
• ICD 10 M54.31 – Sciatica, right side

For left lumbar radiculopathy ICD 10, we use: 

• ICD 10 M54.42 – Lumbago with sciatica, left side
• ICD 10 M54.32 – Sciatica, left side

Bilateral Lumbar Radiculopathy ICD 10

Bilateral lumbar radiculopathy refers to pain or sensation originating from the lumbar spine that runs downward in both legs or feet.

According to ICD 10 guidelines, there is no specific bilateral diagnosis code for radiculopathy in this lower spinal region, so we should always go with M54.16.

Spondylosis With Radiculopathy Lumbar Region ICD 10

Lumbar spondylosis is general degeneration (related to osteoarthritis of spine) of the spine that affects bones, discs, and ligaments and can lead to lumbar radiculopathy in the future. When spondylosis is the cause of radiculopathy, we use ICD 10 CM Code M47.26 – Other spondylosis with radiculopathy lumbar region. When there is only lumbar spondylosis without radiculopathy, we will code it as M47.816.

What Is Lumbar Degenerative Disc Disease (DDD) With Radiculopathy? 

Lumbar DDD is a condition that refers to wear and tear in the lower back spine due to age-related arthritic changes in bones and soft tissues (especially discs) causing back pain or radiating pain in the buttocks and thighs, lower legs, or feet.

Spinal Discs act as shock-absorbing rubbery cushions between intervertebral joints, which allow them to move quickly. When these discs become damaged, the nerve passing above or below is compressed between the vertebrae, causing radiating pain in the legs.

All the Thoracic, thoracolumbar, and lumbosacral intervertebral disc disorders can be found in the M51 category of the ICD 10 CM book (2022 edition).

• M51.16 is a valid billable Diagnosis code for lumbar ddd with radiculopathy ICD 10.

What Is Lumbar Disc Herniation With Radiculopathy? 

The two significant contents of intervertebral discs are nucleus pulposus and annulus fibrosis. Nucleus pulposus is a gel-like watery material found in the center of the disc, covered by annulus fibrosis rings. Annulus fibrosis prevents this gel from oozing out of the center into the surrounding whenever pressure is exerted on it.

When a person moves in an awkward direction or under too much pressure on the disc, this gel-like material oozes out from the annulus fibrous boundaries. As a result, the space between intervertebral joints also decreases, resulting in compression on spinal nerves. This condition is known as Herniated or Displaced disc. It is most common in the lumbar region.

ICD 10 Code For Lumbar Disc Herniation With Radiculopathy

There is not specifically an ICD 10 code for disc herniation with radiculopathy in the lumbar region, so another suitable diagnosis code is given:

• M51.26- Other intervertebral disc displacements, lumbar region

For Lumbosacral (L5-S1) region:

• M51.27- Other intervertebral disc displacement, Lumbosacral region

Spondylosis Of Lumbar Region Without Myelopathy Or Radiculopathy ICD 10

Myelopathy refers to neurological deficit due to severe compression or injury of the spinal cord. The type of myelopathy depends upon the site where it occurs. If it is within the lumbar region, it will be called lumbar myelopathy.

Lumbar myelopathy and spondylosis are two different conditions. So when coding these conditions, we will use two Diagnosis codes in a single line: M47.16 and M47.26.

• M47.16- Other spondylosis with myelopathy, lumbar region
• M47.26- Other spondylosis with radiculopathy, lumbar region

Spondylosis Without Myelopathy Or Radiculopathy Lumbar Region ICD 10

When the condition is lumbar spondylosis alone, without myelopathy and radiculopathy, there is only one correct diagnosis code given which will cover this scenario:

• M47.816– Spondylosis without myelopathy or radiculopathy, lumbar region.

if the affected area is L5-S1 (lumbosacral), then it will be coded as:

• M47.817- Spondylosis without myelopathy or radiculopathy, lumbosacral region.

Lumbar Stenosis With Radiculopathy ICD 10

Stenosis is the spinal canal narrowing that puts pressure on the spinal cord and adjacent structures. Neurogenic claudication is a condition that is caused by stenosis, and it has radiculopathy symptoms such as pain, tingling, prickling, and burning sensations in the buttocks, legs, and feet.

Keeping in mind the above scenario, it is tricky to code in this situation. So, always use the code:

• M48.062- Spinal stenosis, the lumbar region with neurogenic claudication

The above code can also be used in Lumbar foraminal stenosis with radiculopathy.

ICD 11 Codes For Lumbar Radiculopathies

ICD 11 is the eleventh revision of the International Classification of Diseases and has been expected to replace ICD 10 codes soon, contemplated by WHO (World health organization).

When you search for lumbar radiculopathy code in ICD 11 coding tool, you will get only one specific code 8B93.Y-Other specified radiculopathy in matching terms, and this code alone will cover multiple Radiculopathy conditions given below:

• Another specified radiculopathy
• Matching Terms
• Radiculopathy, lumbar region
• Radiculopathy, thoracolumbar region
• Intervertebral disc disorders with radiculopathy lumbar region ICD 10 and other regions

Lumbar Spondylosis With Radiculopathy ICD 11 Code

Unfortunately, no specific code in ICD 11 Coding tool that covers this whole condition. So, in this scenario, we have to choose the most authentic and nearly accurate code, e.g., FA8Z -Degenerative condition of the spine, unspecified.

Lumbar Stenosis With Radiculopathy ICD 11 Code

In ICD 11, No code matches this condition. You can use only other specified radiculopathy code 8B93.Y

Lumbar Disc Herniation With Radiculopathy ICD 11 Code

There is no specific code yet in ICD 11 coding tool for this condition. The most suitable code we can use is:

• 8B93.Y– Other specified radiculopathy