ICD-10-CM Coding Updates: The Big Ones for Chiropractors
DIGITAL EXCLUSIVE
Editor's Note: The following is excerpted from Sam Collins' full-length column in the upcoming November 2022 issue.
As is the case every year, diagnosis codes update on Oct. 1. As always, let's focus on the chiropractic-centric ones. For the lower back, there are new codes specifically to identify annulus fibrous defect (disc) of the lumbar and lumbosacral spines. These new codes do not replace any codes; they simply allow for more specific diagnoses:
M51.A4 Intervertebral annulus fibrosus defect, small, lumbosacral region
M51.A5 Intervertebral annulus fibrosus defect, large, lumbosacral region
These codes identify the effects of the annulus fibrosus of intervertebral discs where the nucleus pulposus tissue herniates. The annulus makes up about 40 percent of the disc, with the peripheral fibers of the annulus fibrosus having the function of anchoring the intervertebral disc to the vertebra. There are existing codes for disc displacement of the lumbar and lumbosacral spine; however, these new codes provide more specificity when the annulus can be identified.
There are also several new codes this year for spinal muscle wasting and atrophy:
M62.5A0 Muscle wasting and atrophy, not elsewhere classified, back, cervical
M62.5A1 Muscle wasting and atrophy, not elsewhere classified, back, thoracic
M62.5A2 Muscle wasting and atrophy, not elsewhere classified, back, lumbosacral
M62.5A9 Muscle wasting and atrophy, not elsewhere classified, back, unspecified
These new codes specifically identify spinal regions; prior, there were no codes specific to the spine, while other body regions (including extremities) did have specific coding.
A historic meeting between chiropractic and Make America Healthy Again (MAHA) leadership took place on March 10th, 2026, in Washington, D.C., featuring representatives from chiropractic national organizations, professional associations and policy principals. The collective goal: advancing the role of chiropractic in improving the health of Americans. Meeting participants focused on long-standing issues that have affected the chiropractic profession for decades, including access to care, reimbursement parity, and ensuring DCs have an appropriate role in national health policy discussions.
Radicular-like pain of the upper and lower extremities is among the most common presentations in musculoskeletal and spine-related practice. Traditionally, these symptoms are interpreted through a disc-centric and dermatomal framework, often leading clinicians to attribute limb pain, paresthesia or perceived weakness to spinal nerve-root pathology. While this approach is appropriate in cases of true radiculopathy, it frequently falls short when symptoms fail to follow consistent dermatomal patterns or correlate poorly with imaging findings.
A 46-year-old male presented to our clinic with a seven-year history of recurrent low back pain with sciatica. He reported stiffness and discomfort that worsened with prolonged sitting both at his desk job and during evening television time. The patient had seen multiple chiropractors over the years. In every case, spinal manipulation and other passive treatments would bring gradual symptom relief over 2-3 months. However, within another 3-6 months, the symptoms would return. Frustrated – and now considering a spinal injection and possibly surgery if that failed, he came to our office seeking a different approach.
