Revenue Cycle Insider

Question: My provider documented an intervertebral annulus fibrosis defect in the lumbar region. I cannot find a code that specifically describes this condition. Which ICD-10-CM code should I report?

Wisconsin Subscriber

Answer: The answer to this will depend on the defect’s size. Most payers consider a defect under 6 mm to be small, whereas they consider a defect measuring 6 mm or greater large. Carragee type I, III, and IV herniations, for example, are also generally treated as small defects.

With additional information from the provider regarding the size of the defect, you’ll choose from the following codes:

• 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).

Lindsey Bush, BA, MA, CPC, Production Editor, AAPC