ICD-10-CM Coding Updates: The Big Ones for Chiropractors

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.A0 Intervertebral annulus fibrosus defect, lumbar region, unspecified size
• M51.A1 Intervertebral annulus fibrosus defect, small, lumbar region
• M51.A2 Intervertebral annulus fibrosus defect, large, lumbar region
• M51.A3 Intervertebral annulus fibrosus defect, lumbosacral region, unspecified size
• 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.