Wiki Lumbar Disc Herniation and Lumbar Radiculopathy

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Lumbar Disc Herniation and Lumbar Radiculopathy

First understand that ICD-10 uses “displacement” to describe “herniation”. In this case, M51.26 Other intervertebral disc displacement, lumbar region is the most specific.

chaimz

Networker
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Hello,

My doctor documents:

1) Lumbar Herniated disc
2) Lumbar Radiculopathy

The two codes that I chose were M51.26, M54.16.

I am questioning this for a combo code: M51.06 - Intervertebral disc disorders with myelopathy, lumbar region. On icd10data.com, under the code's
Approximate Synonyms, it says Herniation of lumbar disc w radiculopathy.

My concern with this is the actual description of the code - Intervertebral disc disorders with myelopathy, lumbar region. "Intervertebral disc disorders" is less specific than "Lumbar Herniated Disc", and since the doctor was specific in documenting "Lumbar Herniated Disc", I believe that M51.06 combo code would be wrong. As well, Radiculopathy refers to the root of the nerve, where as myelopathy refers to the actual spinal cord.

What are your thoughts?
 

sxcoder1

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I disagree with adding M51.26. If you follow the index, it leads to just the one code for all of it, M51.16.
 

AlanPechacek

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Unfortunately, ICD-10 does not use the term "Herniation" for intervertebral disc disorders. It uses "Displacement" instead. If you look up "Hernia, herniated, herniation" in the Alphabetical Index, you will see that for "Herniated Intervertebral Cartilage or Disc (which also includes Nucleus Pulposus)," it says See Displacement, Intervertebral disc. Therefore, "Displacement" equals/is the same as "Herniation/Herniated" disc. Code Set M51 is for Intervertebral disc disorders with Radiculopathy and is less "specific" than M51.2, which is for Intervertebral Disc Displacement (i.e. Herniation) with Radiculopathy. In essence this is a Combination/Manifestation code since it combines the underlying pathology (disc herniation/displacement) with the manifestation (radiculopathy). Therefore, M51.26 is the most specific code since the physician only designated the Lumber Region, not the Lumbosacral disc (M51.27). So write in your code book that disc displacement is the same as disc herniation.

Respectfully submitted, Alan Pechacek, M.D.
icd10orthocoder.com
 
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