SUPERSEDED LCD Reference Article Billing and Coding Article

Billing and Coding: Intraoperative Neurophysiological Testing

A56722

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Draft Article
Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.
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General Information

Source Article ID
N/A
Article ID
A56722
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Intraoperative Neurophysiological Testing
Article Type
Billing and Coding
Original Effective Date
07/25/2019
Revision Effective Date
04/20/2023
Revision Ending Date
09/30/2023
Retirement Date
N/A
AMA CPT / ADA CDT / AHA NUBC Copyright Statement

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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Current Dental Terminology © 2023 American Dental Association. All rights reserved.

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CMS National Coverage Policy

Social Security Act (Title XVIII) Standard References:

  • Title XVIII of the Social Security Act, Section 1833(e) states that no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period.

Article Guidance

Article Text

This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L35003, Intraoperative Neurophysiological Testing. Please refer to the LCD for reasonable and necessary requirements.

Coding Guidance

Notice: It is not appropriate to bill Medicare for services that are not covered (as described by the entire LCD) as if they are covered. When billing for non-covered services, use the appropriate modifier.

CPT Code 95940 is reported per 15 minutes of service. CPT Code 95940 requires reporting only the portion of time the monitoring professional was physically present in the operating room providing one-on-one patient monitoring, and no other cases may be monitored at the same time. Time spent in the operating room is cumulative. To determine units of service of 95940, use the total minutes monitoring in the operating room one-on-one. Monitoring may begin prior to incision (e.g., when positioning on the table is a time of risk). Report continuous intraoperative neurophysiologic monitoring in the operating room (95940) in addition to the services related to monitoring from outside the operating room (G0453), and interpret the baseline studies, and to remove electrodes at the end of the procedure.

When services support the covered indications in the related LCD, reimbursement may be made for the following places of service (POS):

  • Off Campus-Outpatient Hospital (POS 19)
  • Inpatient Hospital (POS 21)
  • On Campus-Outpatient Hospital (POS 22)
  • Ambulatory Surgical Center (POS 24)

Response To Comments

Number Comment Response
1
N/A

Coding Information

Bill Type Codes

Code Description
011x Hospital Inpatient (Including Medicare Part A)
012x Hospital Inpatient (Medicare Part B only)
013x Hospital Outpatient
083x Ambulatory Surgery Center
085x Critical Access Hospital
N/A

Revenue Codes

Code Description
036X Operating Room Services - General Classification
N/A

CPT/HCPCS Codes

Group 1

(2 Codes)
Group 1 Paragraph

Note: Providers are reminded to refer to the long descriptors of the CPT codes in their CPT book.

Group 1 Codes
Code Description
95940 Ionm in operatng room 15 min
G0453 Cont intraop neuro monitor
N/A

CPT/HCPCS Modifiers

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

ICD-10-CM Codes that Support Medical Necessity

Group 1

(818 Codes)
Group 1 Paragraph

It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted.

The following ICD-10-CM codes support medical necessity and provide coverage for CPT/HCPCS codes 95940 and G0453:

Note: ICD-10 code E07.9 is to be reported for an intraoperative neurophysiology monitoring service (CPT/HCPCS codes 95940 or G0453) during a surgical procedure most accurately described by CPT codes 60220, 60240, 60254 or 60260.

Group 1 Codes
Code Description
C41.2 Malignant neoplasm of vertebral column
C70.0 Malignant neoplasm of cerebral meninges
C70.1 Malignant neoplasm of spinal meninges
C70.9 Malignant neoplasm of meninges, unspecified
C72.0 Malignant neoplasm of spinal cord
C72.1 Malignant neoplasm of cauda equina
C72.20 Malignant neoplasm of unspecified olfactory nerve
C72.21 Malignant neoplasm of right olfactory nerve
C72.22 Malignant neoplasm of left olfactory nerve
C72.30 Malignant neoplasm of unspecified optic nerve
C72.31 Malignant neoplasm of right optic nerve
C72.32 Malignant neoplasm of left optic nerve
C72.40 Malignant neoplasm of unspecified acoustic nerve
C72.41 Malignant neoplasm of right acoustic nerve
C72.42 Malignant neoplasm of left acoustic nerve
C72.50 Malignant neoplasm of unspecified cranial nerve
C72.59 Malignant neoplasm of other cranial nerves
C72.9 Malignant neoplasm of central nervous system, unspecified
C73 Malignant neoplasm of thyroid gland
C79.31 Secondary malignant neoplasm of brain
C79.32 Secondary malignant neoplasm of cerebral meninges
C79.40 Secondary malignant neoplasm of unspecified part of nervous system
C79.49 Secondary malignant neoplasm of other parts of nervous system
D21.0 Benign neoplasm of connective and other soft tissue of head, face and neck
D32.0 Benign neoplasm of cerebral meninges
D32.1 Benign neoplasm of spinal meninges
D32.9 Benign neoplasm of meninges, unspecified
D33.0 Benign neoplasm of brain, supratentorial
D33.1 Benign neoplasm of brain, infratentorial
D33.2 Benign neoplasm of brain, unspecified
D33.3 Benign neoplasm of cranial nerves
D33.4 Benign neoplasm of spinal cord
D33.7 Benign neoplasm of other specified parts of central nervous system
D33.9 Benign neoplasm of central nervous system, unspecified
D42.0 Neoplasm of uncertain behavior of cerebral meninges
D42.1 Neoplasm of uncertain behavior of spinal meninges
D42.9 Neoplasm of uncertain behavior of meninges, unspecified
D43.0 Neoplasm of uncertain behavior of brain, supratentorial
D43.1 Neoplasm of uncertain behavior of brain, infratentorial
D43.2 Neoplasm of uncertain behavior of brain, unspecified
D43.3 Neoplasm of uncertain behavior of cranial nerves
D43.4 Neoplasm of uncertain behavior of spinal cord
D43.8 Neoplasm of uncertain behavior of other specified parts of central nervous system
D43.9 Neoplasm of uncertain behavior of central nervous system, unspecified
D44.3 Neoplasm of uncertain behavior of pituitary gland
D44.4 Neoplasm of uncertain behavior of craniopharyngeal duct
D44.5 Neoplasm of uncertain behavior of pineal gland
D44.6 Neoplasm of uncertain behavior of carotid body
D44.7 Neoplasm of uncertain behavior of aortic body and other paraganglia
D49.6 Neoplasm of unspecified behavior of brain
E07.9 Disorder of thyroid, unspecified
G06.1 Intraspinal abscess and granuloma
G40.111 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus
G40.119 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus
G40.211 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus
G40.219 Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, without status epilepticus
G45.0 Vertebro-basilar artery syndrome
G45.1 Carotid artery syndrome (hemispheric)
G45.2 Multiple and bilateral precerebral artery syndromes
G45.8 Other transient cerebral ischemic attacks and related syndromes
G45.9 Transient cerebral ischemic attack, unspecified
G46.0 Middle cerebral artery syndrome
G46.1 Anterior cerebral artery syndrome
G46.2 Posterior cerebral artery syndrome
G50.0 Trigeminal neuralgia
G50.1 Atypical facial pain
G52.9 Cranial nerve disorder, unspecified
G53 Cranial nerve disorders in diseases classified elsewhere
G54.0 Brachial plexus disorders
G54.1 Lumbosacral plexus disorders
G54.2 Cervical root disorders, not elsewhere classified
G54.3 Thoracic root disorders, not elsewhere classified
G54.4 Lumbosacral root disorders, not elsewhere classified
G80.4 Ataxic cerebral palsy
G80.8 Other cerebral palsy
G80.9 Cerebral palsy, unspecified
G83.4 Cauda equina syndrome
G93.5 Compression of brain
G95.0 Syringomyelia and syringobulbia
H71.00 Cholesteatoma of attic, unspecified ear
H71.01 Cholesteatoma of attic, right ear
H71.02 Cholesteatoma of attic, left ear
H71.03 Cholesteatoma of attic, bilateral
H71.10 Cholesteatoma of tympanum, unspecified ear
H71.11 Cholesteatoma of tympanum, right ear
H71.12 Cholesteatoma of tympanum, left ear
H71.13 Cholesteatoma of tympanum, bilateral
H71.20 Cholesteatoma of mastoid, unspecified ear
H71.21 Cholesteatoma of mastoid, right ear
H71.22 Cholesteatoma of mastoid, left ear
H71.23 Cholesteatoma of mastoid, bilateral
H71.30 Diffuse cholesteatosis, unspecified ear
H71.31 Diffuse cholesteatosis, right ear
H71.32 Diffuse cholesteatosis, left ear
H71.33 Diffuse cholesteatosis, bilateral
H71.90 Unspecified cholesteatoma, unspecified ear
H71.91 Unspecified cholesteatoma, right ear
H71.92 Unspecified cholesteatoma, left ear
H71.93 Unspecified cholesteatoma, bilateral
H74.40 Polyp of middle ear, unspecified ear
H74.41 Polyp of right middle ear
H74.42 Polyp of left middle ear
H74.43 Polyp of middle ear, bilateral
H83.11 Labyrinthine fistula, right ear
H83.12 Labyrinthine fistula, left ear
H83.13 Labyrinthine fistula, bilateral
H83.19 Labyrinthine fistula, unspecified ear
I60.00 Nontraumatic subarachnoid hemorrhage from unspecified carotid siphon and bifurcation
I60.01 Nontraumatic subarachnoid hemorrhage from right carotid siphon and bifurcation
I60.02 Nontraumatic subarachnoid hemorrhage from left carotid siphon and bifurcation
I60.10 Nontraumatic subarachnoid hemorrhage from unspecified middle cerebral artery
I60.11 Nontraumatic subarachnoid hemorrhage from right middle cerebral artery
I60.12 Nontraumatic subarachnoid hemorrhage from left middle cerebral artery
I60.2 Nontraumatic subarachnoid hemorrhage from anterior communicating artery
I60.30 Nontraumatic subarachnoid hemorrhage from unspecified posterior communicating artery
I60.31 Nontraumatic subarachnoid hemorrhage from right posterior communicating artery
I60.32 Nontraumatic subarachnoid hemorrhage from left posterior communicating artery
I60.4 Nontraumatic subarachnoid hemorrhage from basilar artery
I60.50 Nontraumatic subarachnoid hemorrhage from unspecified vertebral artery
I60.51 Nontraumatic subarachnoid hemorrhage from right vertebral artery
I60.52 Nontraumatic subarachnoid hemorrhage from left vertebral artery
I60.6 Nontraumatic subarachnoid hemorrhage from other intracranial arteries
I60.7 Nontraumatic subarachnoid hemorrhage from unspecified intracranial artery
I60.8 Other nontraumatic subarachnoid hemorrhage
I60.9 Nontraumatic subarachnoid hemorrhage, unspecified
I61.0 Nontraumatic intracerebral hemorrhage in hemisphere, subcortical
I61.1 Nontraumatic intracerebral hemorrhage in hemisphere, cortical
I61.2 Nontraumatic intracerebral hemorrhage in hemisphere, unspecified
I61.3 Nontraumatic intracerebral hemorrhage in brain stem
I61.4 Nontraumatic intracerebral hemorrhage in cerebellum
I61.5 Nontraumatic intracerebral hemorrhage, intraventricular
I61.6 Nontraumatic intracerebral hemorrhage, multiple localized
I61.8 Other nontraumatic intracerebral hemorrhage
I61.9 Nontraumatic intracerebral hemorrhage, unspecified
I62.00 Nontraumatic subdural hemorrhage, unspecified
I62.01 Nontraumatic acute subdural hemorrhage
I62.02 Nontraumatic subacute subdural hemorrhage
I62.03 Nontraumatic chronic subdural hemorrhage
I62.1 Nontraumatic extradural hemorrhage
I62.9 Nontraumatic intracranial hemorrhage, unspecified
I63.00 Cerebral infarction due to thrombosis of unspecified precerebral artery
I63.011 Cerebral infarction due to thrombosis of right vertebral artery
I63.012 Cerebral infarction due to thrombosis of left vertebral artery
I63.013 Cerebral infarction due to thrombosis of bilateral vertebral arteries
I63.019 Cerebral infarction due to thrombosis of unspecified vertebral artery
I63.02 Cerebral infarction due to thrombosis of basilar artery
I63.031 Cerebral infarction due to thrombosis of right carotid artery
I63.032 Cerebral infarction due to thrombosis of left carotid artery
I63.033 Cerebral infarction due to thrombosis of bilateral carotid arteries
I63.039 Cerebral infarction due to thrombosis of unspecified carotid artery
I63.09 Cerebral infarction due to thrombosis of other precerebral artery
I63.10 Cerebral infarction due to embolism of unspecified precerebral artery
I63.111 Cerebral infarction due to embolism of right vertebral artery
I63.112 Cerebral infarction due to embolism of left vertebral artery
I63.113 Cerebral infarction due to embolism of bilateral vertebral arteries
I63.119 Cerebral infarction due to embolism of unspecified vertebral artery
I63.12 Cerebral infarction due to embolism of basilar artery
I63.131 Cerebral infarction due to embolism of right carotid artery
I63.132 Cerebral infarction due to embolism of left carotid artery
I63.133 Cerebral infarction due to embolism of bilateral carotid arteries
I63.139 Cerebral infarction due to embolism of unspecified carotid artery
I63.19 Cerebral infarction due to embolism of other precerebral artery
I63.20 Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries
I63.211 Cerebral infarction due to unspecified occlusion or stenosis of right vertebral artery
I63.212 Cerebral infarction due to unspecified occlusion or stenosis of left vertebral artery
I63.213 Cerebral infarction due to unspecified occlusion or stenosis of bilateral vertebral arteries
I63.219 Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral artery
I63.22 Cerebral infarction due to unspecified occlusion or stenosis of basilar artery
I63.231 Cerebral infarction due to unspecified occlusion or stenosis of right carotid arteries
I63.232 Cerebral infarction due to unspecified occlusion or stenosis of left carotid arteries
I63.233 Cerebral infarction due to unspecified occlusion or stenosis of bilateral carotid arteries
I63.239 Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid artery
I63.29 Cerebral infarction due to unspecified occlusion or stenosis of other precerebral arteries
I63.30 Cerebral infarction due to thrombosis of unspecified cerebral artery
I63.311 Cerebral infarction due to thrombosis of right middle cerebral artery
I63.312 Cerebral infarction due to thrombosis of left middle cerebral artery
I63.313 Cerebral infarction due to thrombosis of bilateral middle cerebral arteries
I63.319 Cerebral infarction due to thrombosis of unspecified middle cerebral artery
I63.321 Cerebral infarction due to thrombosis of right anterior cerebral artery
I63.322 Cerebral infarction due to thrombosis of left anterior cerebral artery
I63.323 Cerebral infarction due to thrombosis of bilateral anterior cerebral arteries
I63.329 Cerebral infarction due to thrombosis of unspecified anterior cerebral artery
I63.331 Cerebral infarction due to thrombosis of right posterior cerebral artery
I63.332 Cerebral infarction due to thrombosis of left posterior cerebral artery
I63.333 Cerebral infarction due to thrombosis of bilateral posterior cerebral arteries
I63.339 Cerebral infarction due to thrombosis of unspecified posterior cerebral artery
I63.341 Cerebral infarction due to thrombosis of right cerebellar artery
I63.342 Cerebral infarction due to thrombosis of left cerebellar artery
I63.343 Cerebral infarction due to thrombosis of bilateral cerebellar arteries
I63.349 Cerebral infarction due to thrombosis of unspecified cerebellar artery
I63.39 Cerebral infarction due to thrombosis of other cerebral artery
I63.40 Cerebral infarction due to embolism of unspecified cerebral artery
I63.411 Cerebral infarction due to embolism of right middle cerebral artery
I63.412 Cerebral infarction due to embolism of left middle cerebral artery
I63.413 Cerebral infarction due to embolism of bilateral middle cerebral arteries
I63.419 Cerebral infarction due to embolism of unspecified middle cerebral artery
I63.421 Cerebral infarction due to embolism of right anterior cerebral artery
I63.422 Cerebral infarction due to embolism of left anterior cerebral artery
I63.423 Cerebral infarction due to embolism of bilateral anterior cerebral arteries
I63.429 Cerebral infarction due to embolism of unspecified anterior cerebral artery
I63.431 Cerebral infarction due to embolism of right posterior cerebral artery
I63.432 Cerebral infarction due to embolism of left posterior cerebral artery
I63.433 Cerebral infarction due to embolism of bilateral posterior cerebral arteries
I63.439 Cerebral infarction due to embolism of unspecified posterior cerebral artery
I63.441 Cerebral infarction due to embolism of right cerebellar artery
I63.442 Cerebral infarction due to embolism of left cerebellar artery
I63.443 Cerebral infarction due to embolism of bilateral cerebellar arteries
I63.449 Cerebral infarction due to embolism of unspecified cerebellar artery
I63.49 Cerebral infarction due to embolism of other cerebral artery
I63.50 Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery
I63.511 Cerebral infarction due to unspecified occlusion or stenosis of right middle cerebral artery
I63.512 Cerebral infarction due to unspecified occlusion or stenosis of left middle cerebral artery
I63.513 Cerebral infarction due to unspecified occlusion or stenosis of bilateral middle cerebral arteries
I63.519 Cerebral infarction due to unspecified occlusion or stenosis of unspecified middle cerebral artery
I63.521 Cerebral infarction due to unspecified occlusion or stenosis of right anterior cerebral artery
I63.522 Cerebral infarction due to unspecified occlusion or stenosis of left anterior cerebral artery
I63.523 Cerebral infarction due to unspecified occlusion or stenosis of bilateral anterior cerebral arteries
I63.529 Cerebral infarction due to unspecified occlusion or stenosis of unspecified anterior cerebral artery
I63.531 Cerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral artery
I63.532 Cerebral infarction due to unspecified occlusion or stenosis of left posterior cerebral artery
I63.533 Cerebral infarction due to unspecified occlusion or stenosis of bilateral posterior cerebral arteries
I63.539 Cerebral infarction due to unspecified occlusion or stenosis of unspecified posterior cerebral artery
I63.541 Cerebral infarction due to unspecified occlusion or stenosis of right cerebellar artery
I63.542 Cerebral infarction due to unspecified occlusion or stenosis of left cerebellar artery
I63.543 Cerebral infarction due to unspecified occlusion or stenosis of bilateral cerebellar arteries
I63.549 Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebellar artery
I63.59 Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery
I63.6 Cerebral infarction due to cerebral venous thrombosis, nonpyogenic
I63.81 Other cerebral infarction due to occlusion or stenosis of small artery
I63.89 Other cerebral infarction
I63.9 Cerebral infarction, unspecified
I65.01 Occlusion and stenosis of right vertebral artery
I65.02 Occlusion and stenosis of left vertebral artery
I65.03 Occlusion and stenosis of bilateral vertebral arteries
I65.09 Occlusion and stenosis of unspecified vertebral artery
I65.1 Occlusion and stenosis of basilar artery
I65.21 Occlusion and stenosis of right carotid artery
I65.22 Occlusion and stenosis of left carotid artery
I65.23 Occlusion and stenosis of bilateral carotid arteries
I65.29 Occlusion and stenosis of unspecified carotid artery
I65.8 Occlusion and stenosis of other precerebral arteries
I65.9 Occlusion and stenosis of unspecified precerebral artery
I66.01 Occlusion and stenosis of right middle cerebral artery
I66.02 Occlusion and stenosis of left middle cerebral artery
I66.03 Occlusion and stenosis of bilateral middle cerebral arteries
I66.09 Occlusion and stenosis of unspecified middle cerebral artery
I66.11 Occlusion and stenosis of right anterior cerebral artery
I66.12 Occlusion and stenosis of left anterior cerebral artery
I66.13 Occlusion and stenosis of bilateral anterior cerebral arteries
I66.19 Occlusion and stenosis of unspecified anterior cerebral artery
I66.21 Occlusion and stenosis of right posterior cerebral artery
I66.22 Occlusion and stenosis of left posterior cerebral artery
I66.23 Occlusion and stenosis of bilateral posterior cerebral arteries
I66.29 Occlusion and stenosis of unspecified posterior cerebral artery
I66.3 Occlusion and stenosis of cerebellar arteries
I66.8 Occlusion and stenosis of other cerebral arteries
I66.9 Occlusion and stenosis of unspecified cerebral artery
I67.0 Dissection of cerebral arteries, nonruptured
I67.1 Cerebral aneurysm, nonruptured
I67.5 Moyamoya disease
I67.841 Reversible cerebrovascular vasoconstriction syndrome
I67.848 Other cerebrovascular vasospasm and vasoconstriction
I71.00 Dissection of unspecified site of aorta
I71.010 Dissection of ascending aorta
I71.011 Dissection of aortic arch
I71.012 Dissection of descending thoracic aorta
I71.02 Dissection of abdominal aorta
I71.03 Dissection of thoracoabdominal aorta
I71.11 Aneurysm of the ascending aorta, ruptured
I71.12 Aneurysm of the aortic arch, ruptured
I71.13 Aneurysm of the descending thoracic aorta, ruptured
I71.21 Aneurysm of the ascending aorta, without rupture
I71.22 Aneurysm of the aortic arch, without rupture
I71.23 Aneurysm of the descending thoracic aorta, without rupture
I71.31 Pararenal abdominal aortic aneurysm, ruptured
I71.32 Juxtarenal abdominal aortic aneurysm, ruptured
I71.33 Infrarenal abdominal aortic aneurysm, ruptured
I71.41 Pararenal abdominal aortic aneurysm, without rupture
I71.42 Juxtarenal abdominal aortic aneurysm, without rupture
I71.43 Infrarenal abdominal aortic aneurysm, without rupture
I71.51 Supraceliac aneurysm of the abdominal aorta, ruptured
I71.52 Paravisceral aneurysm of the abdominal aorta, ruptured
I71.61 Supraceliac aneurysm of the abdominal aorta, without rupture
I71.62 Paravisceral aneurysm of the abdominal aorta, without rupture
I71.8 Aortic aneurysm of unspecified site, ruptured
I71.9 Aortic aneurysm of unspecified site, without rupture
I77.71 Dissection of carotid artery
I77.74 Dissection of vertebral artery
I77.75 Dissection of other precerebral arteries
I77.79 Dissection of other specified artery
I79.0 Aneurysm of aorta in diseases classified elsewhere
M40.00 Postural kyphosis, site unspecified
M40.03 Postural kyphosis, cervicothoracic region
M40.04 Postural kyphosis, thoracic region
M40.05 Postural kyphosis, thoracolumbar region
M40.10 Other secondary kyphosis, site unspecified
M40.12 Other secondary kyphosis, cervical region
M40.13 Other secondary kyphosis, cervicothoracic region
M40.14 Other secondary kyphosis, thoracic region
M40.15 Other secondary kyphosis, thoracolumbar region
M40.202 Unspecified kyphosis, cervical region
M40.203 Unspecified kyphosis, cervicothoracic region
M40.204 Unspecified kyphosis, thoracic region
M40.205 Unspecified kyphosis, thoracolumbar region
M40.209 Unspecified kyphosis, site unspecified
M40.292 Other kyphosis, cervical region
M40.293 Other kyphosis, cervicothoracic region
M40.294 Other kyphosis, thoracic region
M40.295 Other kyphosis, thoracolumbar region
M40.299 Other kyphosis, site unspecified
M40.30 Flatback syndrome, site unspecified
M40.35 Flatback syndrome, thoracolumbar region
M40.36 Flatback syndrome, lumbar region
M40.37 Flatback syndrome, lumbosacral region
M40.40 Postural lordosis, site unspecified
M40.45 Postural lordosis, thoracolumbar region
M40.46 Postural lordosis, lumbar region
M40.47 Postural lordosis, lumbosacral region
M40.50 Lordosis, unspecified, site unspecified
M40.55 Lordosis, unspecified, thoracolumbar region
M40.56 Lordosis, unspecified, lumbar region
M40.57 Lordosis, unspecified, lumbosacral region
M41.00 Infantile idiopathic scoliosis, site unspecified
M41.02 Infantile idiopathic scoliosis, cervical region
M41.03 Infantile idiopathic scoliosis, cervicothoracic region
M41.04 Infantile idiopathic scoliosis, thoracic region
M41.05 Infantile idiopathic scoliosis, thoracolumbar region
M41.06 Infantile idiopathic scoliosis, lumbar region
M41.07 Infantile idiopathic scoliosis, lumbosacral region
M41.08 Infantile idiopathic scoliosis, sacral and sacrococcygeal region
M41.112 Juvenile idiopathic scoliosis, cervical region
M41.113 Juvenile idiopathic scoliosis, cervicothoracic region
M41.114 Juvenile idiopathic scoliosis, thoracic region
M41.115 Juvenile idiopathic scoliosis, thoracolumbar region
M41.116 Juvenile idiopathic scoliosis, lumbar region
M41.117 Juvenile idiopathic scoliosis, lumbosacral region
M41.119 Juvenile idiopathic scoliosis, site unspecified
M41.122 Adolescent idiopathic scoliosis, cervical region
M41.123 Adolescent idiopathic scoliosis, cervicothoracic region
M41.124 Adolescent idiopathic scoliosis, thoracic region
M41.125 Adolescent idiopathic scoliosis, thoracolumbar region
M41.126 Adolescent idiopathic scoliosis, lumbar region
M41.127 Adolescent idiopathic scoliosis, lumbosacral region
M41.129 Adolescent idiopathic scoliosis, site unspecified
M41.20 Other idiopathic scoliosis, site unspecified
M41.22 Other idiopathic scoliosis, cervical region
M41.23 Other idiopathic scoliosis, cervicothoracic region
M41.24 Other idiopathic scoliosis, thoracic region
M41.25 Other idiopathic scoliosis, thoracolumbar region
M41.26 Other idiopathic scoliosis, lumbar region
M41.27 Other idiopathic scoliosis, lumbosacral region
M41.30 Thoracogenic scoliosis, site unspecified
M41.34 Thoracogenic scoliosis, thoracic region
M41.35 Thoracogenic scoliosis, thoracolumbar region
M41.40 Neuromuscular scoliosis, site unspecified
M41.41 Neuromuscular scoliosis, occipito-atlanto-axial region
M41.42 Neuromuscular scoliosis, cervical region
M41.43 Neuromuscular scoliosis, cervicothoracic region
M41.44 Neuromuscular scoliosis, thoracic region
M41.45 Neuromuscular scoliosis, thoracolumbar region
M41.46 Neuromuscular scoliosis, lumbar region
M41.47 Neuromuscular scoliosis, lumbosacral region
M41.50 Other secondary scoliosis, site unspecified
M41.52 Other secondary scoliosis, cervical region
M41.53 Other secondary scoliosis, cervicothoracic region
M41.54 Other secondary scoliosis, thoracic region
M41.55 Other secondary scoliosis, thoracolumbar region
M41.56 Other secondary scoliosis, lumbar region
M41.57 Other secondary scoliosis, lumbosacral region
M41.80 Other forms of scoliosis, site unspecified
M41.82 Other forms of scoliosis, cervical region
M41.83 Other forms of scoliosis, cervicothoracic region
M41.84 Other forms of scoliosis, thoracic region
M41.85 Other forms of scoliosis, thoracolumbar region
M41.86 Other forms of scoliosis, lumbar region
M41.87 Other forms of scoliosis, lumbosacral region
M41.9 Scoliosis, unspecified
M43.01 Spondylolysis, occipito-atlanto-axial region
M43.02 Spondylolysis, cervical region
M43.03 Spondylolysis, cervicothoracic region
M43.04 Spondylolysis, thoracic region
M43.05 Spondylolysis, thoracolumbar region
M43.06 Spondylolysis, lumbar region
M43.07 Spondylolysis, lumbosacral region
M43.08 Spondylolysis, sacral and sacrococcygeal region
M43.09 Spondylolysis, multiple sites in spine
M43.11 Spondylolisthesis, occipito-atlanto-axial region
M43.12 Spondylolisthesis, cervical region
M43.13 Spondylolisthesis, cervicothoracic region
M43.14 Spondylolisthesis, thoracic region
M43.15 Spondylolisthesis, thoracolumbar region
M43.16 Spondylolisthesis, lumbar region
M43.17 Spondylolisthesis, lumbosacral region
M43.18 Spondylolisthesis, sacral and sacrococcygeal region
M43.19 Spondylolisthesis, multiple sites in spine
M43.8X1 Other specified deforming dorsopathies, occipito-atlanto-axial region
M43.8X2 Other specified deforming dorsopathies, cervical region
M43.8X3 Other specified deforming dorsopathies, cervicothoracic region
M43.8X4 Other specified deforming dorsopathies, thoracic region
M43.8X5 Other specified deforming dorsopathies, thoracolumbar region
M43.8X6 Other specified deforming dorsopathies, lumbar region
M43.8X7 Other specified deforming dorsopathies, lumbosacral region
M43.8X8 Other specified deforming dorsopathies, sacral and sacrococcygeal region
M43.8X9 Other specified deforming dorsopathies, site unspecified
M43.9 Deforming dorsopathy, unspecified
M47.011 Anterior spinal artery compression syndromes, occipito-atlanto-axial region
M47.012 Anterior spinal artery compression syndromes, cervical region
M47.013 Anterior spinal artery compression syndromes, cervicothoracic region
M47.014 Anterior spinal artery compression syndromes, thoracic region
M47.015 Anterior spinal artery compression syndromes, thoracolumbar region
M47.016 Anterior spinal artery compression syndromes, lumbar region
M47.019 Anterior spinal artery compression syndromes, site unspecified
M47.021 Vertebral artery compression syndromes, occipito-atlanto-axial region
M47.022 Vertebral artery compression syndromes, cervical region
M47.029 Vertebral artery compression syndromes, site unspecified
M47.10 Other spondylosis with myelopathy, site unspecified
M47.11 Other spondylosis with myelopathy, occipito-atlanto-axial region
M47.12 Other spondylosis with myelopathy, cervical region
M47.13 Other spondylosis with myelopathy, cervicothoracic region
M47.14 Other spondylosis with myelopathy, thoracic region
M47.15 Other spondylosis with myelopathy, thoracolumbar region
M47.16 Other spondylosis with myelopathy, lumbar region
M47.21 Other spondylosis with radiculopathy, occipito-atlanto-axial region
M47.22 Other spondylosis with radiculopathy, cervical region
M47.23 Other spondylosis with radiculopathy, cervicothoracic region
M47.24 Other spondylosis with radiculopathy, thoracic region
M47.25 Other spondylosis with radiculopathy, thoracolumbar region
M47.26 Other spondylosis with radiculopathy, lumbar region
M47.27 Other spondylosis with radiculopathy, lumbosacral region
M47.28 Other spondylosis with radiculopathy, sacral and sacrococcygeal region
M47.811 Spondylosis without myelopathy or radiculopathy, occipito-atlanto-axial region
M47.812 Spondylosis without myelopathy or radiculopathy, cervical region
M47.813 Spondylosis without myelopathy or radiculopathy, cervicothoracic region
M47.816 Spondylosis without myelopathy or radiculopathy, lumbar region
M47.817 Spondylosis without myelopathy or radiculopathy, lumbosacral region
M47.818 Spondylosis without myelopathy or radiculopathy, sacral and sacrococcygeal region
M47.891 Other spondylosis, occipito-atlanto-axial region
M47.892 Other spondylosis, cervical region
M47.893 Other spondylosis, cervicothoracic region
M47.896 Other spondylosis, lumbar region
M47.897 Other spondylosis, lumbosacral region
M47.898 Other spondylosis, sacral and sacrococcygeal region
M48.01 Spinal stenosis, occipito-atlanto-axial region
M48.02 Spinal stenosis, cervical region
M48.03 Spinal stenosis, cervicothoracic region
M48.062 Spinal stenosis, lumbar region with neurogenic claudication
M48.07 Spinal stenosis, lumbosacral region
M50.00 Cervical disc disorder with myelopathy, unspecified cervical region
M50.01 Cervical disc disorder with myelopathy, high cervical region
M50.021 Cervical disc disorder at C4-C5 level with myelopathy
M50.022 Cervical disc disorder at C5-C6 level with myelopathy
M50.023 Cervical disc disorder at C6-C7 level with myelopathy
M50.03 Cervical disc disorder with myelopathy, cervicothoracic region
M50.11 Cervical disc disorder with radiculopathy, high cervical region
M50.121 Cervical disc disorder at C4-C5 level with radiculopathy
M50.122 Cervical disc disorder at C5-C6 level with radiculopathy
M50.123 Cervical disc disorder at C6-C7 level with radiculopathy
M50.21 Other cervical disc displacement, high cervical region
M50.221 Other cervical disc displacement at C4-C5 level
M50.222 Other cervical disc displacement at C5-C6 level
M50.223 Other cervical disc displacement at C6-C7 level
M50.23 Other cervical disc displacement, cervicothoracic region
M50.31 Other cervical disc degeneration, high cervical region
M50.321 Other cervical disc degeneration at C4-C5 level
M50.322 Other cervical disc degeneration at C5-C6 level
M50.323 Other cervical disc degeneration at C6-C7 level
M50.33 Other cervical disc degeneration, cervicothoracic region
M51.04 Intervertebral disc disorders with myelopathy, thoracic region
M51.05 Intervertebral disc disorders with myelopathy, thoracolumbar region
M51.06 Intervertebral disc disorders with myelopathy, lumbar region
M51.14 Intervertebral disc disorders with radiculopathy, thoracic region
M51.15 Intervertebral disc disorders with radiculopathy, thoracolumbar region
M51.16 Intervertebral disc disorders with radiculopathy, lumbar region
M51.17 Intervertebral disc disorders with radiculopathy, lumbosacral region
M51.24 Other intervertebral disc displacement, thoracic region
M51.25 Other intervertebral disc displacement, thoracolumbar region
M51.26 Other intervertebral disc displacement, lumbar region
M51.27 Other intervertebral disc displacement, lumbosacral region
M51.34 Other intervertebral disc degeneration, thoracic region
M51.35 Other intervertebral disc degeneration, thoracolumbar region
M51.36 Other intervertebral disc degeneration, lumbar region
M51.37 Other intervertebral disc degeneration, lumbosacral region
M51.9 Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder
M54.11 Radiculopathy, occipito-atlanto-axial region
M54.12 Radiculopathy, cervical region
M54.13 Radiculopathy, cervicothoracic region
M54.14 Radiculopathy, thoracic region
M54.15 Radiculopathy, thoracolumbar region
M54.16 Radiculopathy, lumbar region
M54.17 Radiculopathy, lumbosacral region
M54.18 Radiculopathy, sacral and sacrococcygeal region
M96.1 Postlaminectomy syndrome, not elsewhere classified
M96.2 Postradiation kyphosis
M96.3 Postlaminectomy kyphosis
M96.4 Postsurgical lordosis
M96.5 Postradiation scoliosis
M99.20 Subluxation stenosis of neural canal of head region
M99.21 Subluxation stenosis of neural canal of cervical region
M99.22 Subluxation stenosis of neural canal of thoracic region
M99.23 Subluxation stenosis of neural canal of lumbar region
M99.24 Subluxation stenosis of neural canal of sacral region
M99.30 Osseous stenosis of neural canal of head region
M99.31 Osseous stenosis of neural canal of cervical region
M99.32 Osseous stenosis of neural canal of thoracic region
M99.33 Osseous stenosis of neural canal of lumbar region
M99.34 Osseous stenosis of neural canal of sacral region
M99.40 Connective tissue stenosis of neural canal of head region
M99.41 Connective tissue stenosis of neural canal of cervical region
M99.42 Connective tissue stenosis of neural canal of thoracic region
M99.43 Connective tissue stenosis of neural canal of lumbar region
M99.44 Connective tissue stenosis of neural canal of sacral region
M99.50 Intervertebral disc stenosis of neural canal of head region
M99.51 Intervertebral disc stenosis of neural canal of cervical region
M99.52 Intervertebral disc stenosis of neural canal of thoracic region
M99.53 Intervertebral disc stenosis of neural canal of lumbar region
M99.54 Intervertebral disc stenosis of neural canal of sacral region
M99.60 Osseous and subluxation stenosis of intervertebral foramina of head region
M99.61 Osseous and subluxation stenosis of intervertebral foramina of cervical region
M99.62 Osseous and subluxation stenosis of intervertebral foramina of thoracic region
M99.63 Osseous and subluxation stenosis of intervertebral foramina of lumbar region
M99.64 Osseous and subluxation stenosis of intervertebral foramina of sacral region
M99.70 Connective tissue and disc stenosis of intervertebral foramina of head region
M99.71 Connective tissue and disc stenosis of intervertebral foramina of cervical region
M99.72 Connective tissue and disc stenosis of intervertebral foramina of thoracic region
M99.73 Connective tissue and disc stenosis of intervertebral foramina of lumbar region
M99.74 Connective tissue and disc stenosis of intervertebral foramina of sacral region
P11.3 Birth injury to facial nerve
P11.4 Birth injury to other cranial nerves
P11.5 Birth injury to spine and spinal cord
P14.0 Erb's paralysis due to birth injury
P14.1 Klumpke's paralysis due to birth injury
P14.2 Phrenic nerve paralysis due to birth injury
P14.3 Other brachial plexus birth injuries
P14.8 Birth injuries to other parts of peripheral nervous system
P14.9 Birth injury to peripheral nervous system, unspecified
Q05.0 Cervical spina bifida with hydrocephalus
Q05.1 Thoracic spina bifida with hydrocephalus
Q05.2 Lumbar spina bifida with hydrocephalus
Q05.3 Sacral spina bifida with hydrocephalus
Q05.4 Unspecified spina bifida with hydrocephalus
Q05.5 Cervical spina bifida without hydrocephalus
Q05.6 Thoracic spina bifida without hydrocephalus
Q05.7 Lumbar spina bifida without hydrocephalus
Q05.8 Sacral spina bifida without hydrocephalus
Q05.9 Spina bifida, unspecified
Q07.00 Arnold-Chiari syndrome without spina bifida or hydrocephalus
Q07.01 Arnold-Chiari syndrome with spina bifida
Q07.02 Arnold-Chiari syndrome with hydrocephalus
Q07.03 Arnold-Chiari syndrome with spina bifida and hydrocephalus
Q27.9 Congenital malformation of peripheral vascular system, unspecified
Q28.2 Arteriovenous malformation of cerebral vessels
Q28.3 Other malformations of cerebral vessels
Q85.00 Neurofibromatosis, unspecified
Q85.01 Neurofibromatosis, type 1
Q85.02 Neurofibromatosis, type 2
Q85.03 Schwannomatosis
Q85.09 Other neurofibromatosis
S12.000A Unspecified displaced fracture of first cervical vertebra, initial encounter for closed fracture
S12.000B Unspecified displaced fracture of first cervical vertebra, initial encounter for open fracture
S12.001A Unspecified nondisplaced fracture of first cervical vertebra, initial encounter for closed fracture
S12.001B Unspecified nondisplaced fracture of first cervical vertebra, initial encounter for open fracture
S12.100A Unspecified displaced fracture of second cervical vertebra, initial encounter for closed fracture
S12.100B Unspecified displaced fracture of second cervical vertebra, initial encounter for open fracture
S12.101A Unspecified nondisplaced fracture of second cervical vertebra, initial encounter for closed fracture
S12.101B Unspecified nondisplaced fracture of second cervical vertebra, initial encounter for open fracture
S12.200A Unspecified displaced fracture of third cervical vertebra, initial encounter for closed fracture
S12.200B Unspecified displaced fracture of third cervical vertebra, initial encounter for open fracture
S12.201A Unspecified nondisplaced fracture of third cervical vertebra, initial encounter for closed fracture
S12.201B Unspecified nondisplaced fracture of third cervical vertebra, initial encounter for open fracture
S12.300A Unspecified displaced fracture of fourth cervical vertebra, initial encounter for closed fracture
S12.300B Unspecified displaced fracture of fourth cervical vertebra, initial encounter for open fracture
S12.301A Unspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for closed fracture
S12.301B Unspecified nondisplaced fracture of fourth cervical vertebra, initial encounter for open fracture
S12.400A Unspecified displaced fracture of fifth cervical vertebra, initial encounter for closed fracture
S12.400B Unspecified displaced fracture of fifth cervical vertebra, initial encounter for open fracture
S12.401A Unspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for closed fracture
S12.401B Unspecified nondisplaced fracture of fifth cervical vertebra, initial encounter for open fracture
S12.500A Unspecified displaced fracture of sixth cervical vertebra, initial encounter for closed fracture
S12.500B Unspecified displaced fracture of sixth cervical vertebra, initial encounter for open fracture
S12.501A Unspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for closed fracture
S12.501B Unspecified nondisplaced fracture of sixth cervical vertebra, initial encounter for open fracture
S12.600A Unspecified displaced fracture of seventh cervical vertebra, initial encounter for closed fracture
S12.600B Unspecified displaced fracture of seventh cervical vertebra, initial encounter for open fracture
S12.601A Unspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for closed fracture
S12.601B Unspecified nondisplaced fracture of seventh cervical vertebra, initial encounter for open fracture
S12.9XXA Fracture of neck, unspecified, initial encounter
S14.101A Unspecified injury at C1 level of cervical spinal cord, initial encounter
S14.102A Unspecified injury at C2 level of cervical spinal cord, initial encounter
S14.103A Unspecified injury at C3 level of cervical spinal cord, initial encounter
S14.104A Unspecified injury at C4 level of cervical spinal cord, initial encounter
S14.105A Unspecified injury at C5 level of cervical spinal cord, initial encounter
S14.106A Unspecified injury at C6 level of cervical spinal cord, initial encounter
S14.107A Unspecified injury at C7 level of cervical spinal cord, initial encounter
S14.109A Unspecified injury at unspecified level of cervical spinal cord, initial encounter
S14.111A Complete lesion at C1 level of cervical spinal cord, initial encounter
S14.112A Complete lesion at C2 level of cervical spinal cord, initial encounter
S14.113A Complete lesion at C3 level of cervical spinal cord, initial encounter
S14.114A Complete lesion at C4 level of cervical spinal cord, initial encounter
S14.115A Complete lesion at C5 level of cervical spinal cord, initial encounter
S14.116A Complete lesion at C6 level of cervical spinal cord, initial encounter
S14.117A Complete lesion at C7 level of cervical spinal cord, initial encounter
S14.121A Central cord syndrome at C1 level of cervical spinal cord, initial encounter
S14.122A Central cord syndrome at C2 level of cervical spinal cord, initial encounter
S14.123A Central cord syndrome at C3 level of cervical spinal cord, initial encounter
S14.124A Central cord syndrome at C4 level of cervical spinal cord, initial encounter
S14.125A Central cord syndrome at C5 level of cervical spinal cord, initial encounter
S14.126A Central cord syndrome at C6 level of cervical spinal cord, initial encounter
S14.127A Central cord syndrome at C7 level of cervical spinal cord, initial encounter
S14.131A Anterior cord syndrome at C1 level of cervical spinal cord, initial encounter
S14.132A Anterior cord syndrome at C2 level of cervical spinal cord, initial encounter
S14.133A Anterior cord syndrome at C3 level of cervical spinal cord, initial encounter
S14.134A Anterior cord syndrome at C4 level of cervical spinal cord, initial encounter
S14.135A Anterior cord syndrome at C5 level of cervical spinal cord, initial encounter
S14.136A Anterior cord syndrome at C6 level of cervical spinal cord, initial encounter
S14.137A Anterior cord syndrome at C7 level of cervical spinal cord, initial encounter
S14.151A Other incomplete lesion at C1 level of cervical spinal cord, initial encounter
S14.152A Other incomplete lesion at C2 level of cervical spinal cord, initial encounter
S14.153A Other incomplete lesion at C3 level of cervical spinal cord, initial encounter
S14.154A Other incomplete lesion at C4 level of cervical spinal cord, initial encounter
S14.155A Other incomplete lesion at C5 level of cervical spinal cord, initial encounter
S14.156A Other incomplete lesion at C6 level of cervical spinal cord, initial encounter
S14.157A Other incomplete lesion at C7 level of cervical spinal cord, initial encounter
S14.2XXA Injury of nerve root of cervical spine, initial encounter
S14.3XXA Injury of brachial plexus, initial encounter
S22.009A Unspecified fracture of unspecified thoracic vertebra, initial encounter for closed fracture
S22.009B Unspecified fracture of unspecified thoracic vertebra, initial encounter for open fracture
S22.019A Unspecified fracture of first thoracic vertebra, initial encounter for closed fracture
S22.019B Unspecified fracture of first thoracic vertebra, initial encounter for open fracture
S22.029A Unspecified fracture of second thoracic vertebra, initial encounter for closed fracture
S22.029B Unspecified fracture of second thoracic vertebra, initial encounter for open fracture
S22.039A Unspecified fracture of third thoracic vertebra, initial encounter for closed fracture
S22.039B Unspecified fracture of third thoracic vertebra, initial encounter for open fracture
S22.049A Unspecified fracture of fourth thoracic vertebra, initial encounter for closed fracture
S22.049B Unspecified fracture of fourth thoracic vertebra, initial encounter for open fracture
S22.059A Unspecified fracture of T5-T6 vertebra, initial encounter for closed fracture
S22.059B Unspecified fracture of T5-T6 vertebra, initial encounter for open fracture
S22.069A Unspecified fracture of T7-T8 vertebra, initial encounter for closed fracture
S22.069B Unspecified fracture of T7-T8 vertebra, initial encounter for open fracture
S22.079A Unspecified fracture of T9-T10 vertebra, initial encounter for closed fracture
S22.079B Unspecified fracture of T9-T10 vertebra, initial encounter for open fracture
S22.089A Unspecified fracture of T11-T12 vertebra, initial encounter for closed fracture
S22.089B Unspecified fracture of T11-T12 vertebra, initial encounter for open fracture
S24.101A Unspecified injury at T1 level of thoracic spinal cord, initial encounter
S24.102A Unspecified injury at T2-T6 level of thoracic spinal cord, initial encounter
S24.103A Unspecified injury at T7-T10 level of thoracic spinal cord, initial encounter
S24.104A Unspecified injury at T11-T12 level of thoracic spinal cord, initial encounter
S24.109A Unspecified injury at unspecified level of thoracic spinal cord, initial encounter
S24.111A Complete lesion at T1 level of thoracic spinal cord, initial encounter
S24.112A Complete lesion at T2-T6 level of thoracic spinal cord, initial encounter
S24.113A Complete lesion at T7-T10 level of thoracic spinal cord, initial encounter
S24.114A Complete lesion at T11-T12 level of thoracic spinal cord, initial encounter
S24.131A Anterior cord syndrome at T1 level of thoracic spinal cord, initial encounter
S24.132A Anterior cord syndrome at T2-T6 level of thoracic spinal cord, initial encounter
S24.133A Anterior cord syndrome at T7-T10 level of thoracic spinal cord, initial encounter
S24.134A Anterior cord syndrome at T11-T12 level of thoracic spinal cord, initial encounter
S24.151A Other incomplete lesion at T1 level of thoracic spinal cord, initial encounter
S24.152A Other incomplete lesion at T2-T6 level of thoracic spinal cord, initial encounter
S24.153A Other incomplete lesion at T7-T10 level of thoracic spinal cord, initial encounter
S24.154A Other incomplete lesion at T11-T12 level of thoracic spinal cord, initial encounter
S24.2XXA Injury of nerve root of thoracic spine, initial encounter
S32.009A Unspecified fracture of unspecified lumbar vertebra, initial encounter for closed fracture
S32.009B Unspecified fracture of unspecified lumbar vertebra, initial encounter for open fracture
S32.019A Unspecified fracture of first lumbar vertebra, initial encounter for closed fracture
S32.019B Unspecified fracture of first lumbar vertebra, initial encounter for open fracture
S32.029A Unspecified fracture of second lumbar vertebra, initial encounter for closed fracture
S32.029B Unspecified fracture of second lumbar vertebra, initial encounter for open fracture
S32.039A Unspecified fracture of third lumbar vertebra, initial encounter for closed fracture
S32.039B Unspecified fracture of third lumbar vertebra, initial encounter for open fracture
S32.049A Unspecified fracture of fourth lumbar vertebra, initial encounter for closed fracture
S32.049B Unspecified fracture of fourth lumbar vertebra, initial encounter for open fracture
S32.059A Unspecified fracture of fifth lumbar vertebra, initial encounter for closed fracture
S32.059B Unspecified fracture of fifth lumbar vertebra, initial encounter for open fracture
S32.10XA Unspecified fracture of sacrum, initial encounter for closed fracture
S32.10XB Unspecified fracture of sacrum, initial encounter for open fracture
S32.2XXB Fracture of coccyx, initial encounter for open fracture
S34.101A Unspecified injury to L1 level of lumbar spinal cord, initial encounter
S34.102A Unspecified injury to L2 level of lumbar spinal cord, initial encounter
S34.103A Unspecified injury to L3 level of lumbar spinal cord, initial encounter
S34.104A Unspecified injury to L4 level of lumbar spinal cord, initial encounter
S34.105A Unspecified injury to L5 level of lumbar spinal cord, initial encounter
S34.109A Unspecified injury to unspecified level of lumbar spinal cord, initial encounter
S34.111A Complete lesion of L1 level of lumbar spinal cord, initial encounter
S34.112A Complete lesion of L2 level of lumbar spinal cord, initial encounter
S34.113A Complete lesion of L3 level of lumbar spinal cord, initial encounter
S34.114A Complete lesion of L4 level of lumbar spinal cord, initial encounter
S34.115A Complete lesion of L5 level of lumbar spinal cord, initial encounter
S34.119A Complete lesion of unspecified level of lumbar spinal cord, initial encounter
S34.121A Incomplete lesion of L1 level of lumbar spinal cord, initial encounter
S34.122A Incomplete lesion of L2 level of lumbar spinal cord, initial encounter
S34.123A Incomplete lesion of L3 level of lumbar spinal cord, initial encounter
S34.124A Incomplete lesion of L4 level of lumbar spinal cord, initial encounter
S34.125A Incomplete lesion of L5 level of lumbar spinal cord, initial encounter
S34.129A Incomplete lesion of unspecified level of lumbar spinal cord, initial encounter
S34.131A Complete lesion of sacral spinal cord, initial encounter
S34.132A Incomplete lesion of sacral spinal cord, initial encounter
S34.139A Unspecified injury to sacral spinal cord, initial encounter
S34.21XA Injury of nerve root of lumbar spine, initial encounter
S34.22XA Injury of nerve root of sacral spine, initial encounter
S34.3XXA Injury of cauda equina, initial encounter
S34.4XXA Injury of lumbosacral plexus, initial encounter
S44.00XA Injury of ulnar nerve at upper arm level, unspecified arm, initial encounter
S44.01XA Injury of ulnar nerve at upper arm level, right arm, initial encounter
S44.02XA Injury of ulnar nerve at upper arm level, left arm, initial encounter
S44.10XA Injury of median nerve at upper arm level, unspecified arm, initial encounter
S44.11XA Injury of median nerve at upper arm level, right arm, initial encounter
S44.12XA Injury of median nerve at upper arm level, left arm, initial encounter
S44.20XA Injury of radial nerve at upper arm level, unspecified arm, initial encounter
S44.21XA Injury of radial nerve at upper arm level, right arm, initial encounter
S44.22XA Injury of radial nerve at upper arm level, left arm, initial encounter
S44.30XA Injury of axillary nerve, unspecified arm, initial encounter
S44.31XA Injury of axillary nerve, right arm, initial encounter
S44.32XA Injury of axillary nerve, left arm, initial encounter
S44.40XA Injury of musculocutaneous nerve, unspecified arm, initial encounter
S44.41XA Injury of musculocutaneous nerve, right arm, initial encounter
S44.42XA Injury of musculocutaneous nerve, left arm, initial encounter
S44.50XA Injury of cutaneous sensory nerve at shoulder and upper arm level, unspecified arm, initial encounter
S44.51XA Injury of cutaneous sensory nerve at shoulder and upper arm level, right arm, initial encounter
S44.52XA Injury of cutaneous sensory nerve at shoulder and upper arm level, left arm, initial encounter
S44.8X1A Injury of other nerves at shoulder and upper arm level, right arm, initial encounter
S44.8X2A Injury of other nerves at shoulder and upper arm level, left arm, initial encounter
S44.8X9A Injury of other nerves at shoulder and upper arm level, unspecified arm, initial encounter
S44.90XA Injury of unspecified nerve at shoulder and upper arm level, unspecified arm, initial encounter
S44.91XA Injury of unspecified nerve at shoulder and upper arm level, right arm, initial encounter
S44.92XA Injury of unspecified nerve at shoulder and upper arm level, left arm, initial encounter
S54.00XA Injury of ulnar nerve at forearm level, unspecified arm, initial encounter
S54.01XA Injury of ulnar nerve at forearm level, right arm, initial encounter
S54.02XA Injury of ulnar nerve at forearm level, left arm, initial encounter
S54.10XA Injury of median nerve at forearm level, unspecified arm, initial encounter
S54.11XA Injury of median nerve at forearm level, right arm, initial encounter
S54.12XA Injury of median nerve at forearm level, left arm, initial encounter
S54.20XA Injury of radial nerve at forearm level, unspecified arm, initial encounter
S54.21XA Injury of radial nerve at forearm level, right arm, initial encounter
S54.22XA Injury of radial nerve at forearm level, left arm, initial encounter
S54.30XA Injury of cutaneous sensory nerve at forearm level, unspecified arm, initial encounter
S54.31XA Injury of cutaneous sensory nerve at forearm level, right arm, initial encounter
S54.32XA Injury of cutaneous sensory nerve at forearm level, left arm, initial encounter
S54.8X1A Injury of other nerves at forearm level, right arm, initial encounter
S54.8X2A Injury of other nerves at forearm level, left arm, initial encounter
S54.8X9A Injury of other nerves at forearm level, unspecified arm, initial encounter
S54.90XA Injury of unspecified nerve at forearm level, unspecified arm, initial encounter
S54.91XA Injury of unspecified nerve at forearm level, right arm, initial encounter
S54.92XA Injury of unspecified nerve at forearm level, left arm, initial encounter
S64.00XA Injury of ulnar nerve at wrist and hand level of unspecified arm, initial encounter
S64.01XA Injury of ulnar nerve at wrist and hand level of right arm, initial encounter
S64.02XA Injury of ulnar nerve at wrist and hand level of left arm, initial encounter
S64.10XA Injury of median nerve at wrist and hand level of unspecified arm, initial encounter
S64.11XA Injury of median nerve at wrist and hand level of right arm, initial encounter
S64.12XA Injury of median nerve at wrist and hand level of left arm, initial encounter
S64.20XA Injury of radial nerve at wrist and hand level of unspecified arm, initial encounter
S64.21XA Injury of radial nerve at wrist and hand level of right arm, initial encounter
S64.22XA Injury of radial nerve at wrist and hand level of left arm, initial encounter
S64.30XA Injury of digital nerve of unspecified thumb, initial encounter
S64.31XA Injury of digital nerve of right thumb, initial encounter
S64.32XA Injury of digital nerve of left thumb, initial encounter
S64.40XA Injury of digital nerve of unspecified finger, initial encounter
S64.490A Injury of digital nerve of right index finger, initial encounter
S64.491A Injury of digital nerve of left index finger, initial encounter
S64.492A Injury of digital nerve of right middle finger, initial encounter
S64.493A Injury of digital nerve of left middle finger, initial encounter
S64.494A Injury of digital nerve of right ring finger, initial encounter
S64.495A Injury of digital nerve of left ring finger, initial encounter
S64.496A Injury of digital nerve of right little finger, initial encounter
S64.497A Injury of digital nerve of left little finger, initial encounter
S64.498A Injury of digital nerve of other finger, initial encounter
S64.8X1A Injury of other nerves at wrist and hand level of right arm, initial encounter
S64.8X2A Injury of other nerves at wrist and hand level of left arm, initial encounter
S64.8X9A Injury of other nerves at wrist and hand level of unspecified arm, initial encounter
S64.90XA Injury of unspecified nerve at wrist and hand level of unspecified arm, initial encounter
S64.91XA Injury of unspecified nerve at wrist and hand level of right arm, initial encounter
S64.92XA Injury of unspecified nerve at wrist and hand level of left arm, initial encounter
S74.00XA Injury of sciatic nerve at hip and thigh level, unspecified leg, initial encounter
S74.01XA Injury of sciatic nerve at hip and thigh level, right leg, initial encounter
S74.02XA Injury of sciatic nerve at hip and thigh level, left leg, initial encounter
S74.10XA Injury of femoral nerve at hip and thigh level, unspecified leg, initial encounter
S74.11XA Injury of femoral nerve at hip and thigh level, right leg, initial encounter
S74.12XA Injury of femoral nerve at hip and thigh level, left leg, initial encounter
S74.20XA Injury of cutaneous sensory nerve at hip and thigh level, unspecified leg, initial encounter
S74.21XA Injury of cutaneous sensory nerve at hip and high level, right leg, initial encounter
S74.22XA Injury of cutaneous sensory nerve at hip and thigh level, left leg, initial encounter
S74.8X1A Injury of other nerves at hip and thigh level, right leg, initial encounter
S74.8X2A Injury of other nerves at hip and thigh level, left leg, initial encounter
S74.8X9A Injury of other nerves at hip and thigh level, unspecified leg, initial encounter
S74.90XA Injury of unspecified nerve at hip and thigh level, unspecified leg, initial encounter
S74.91XA Injury of unspecified nerve at hip and thigh level, right leg, initial encounter
S74.92XA Injury of unspecified nerve at hip and thigh level, left leg, initial encounter
S84.00XA Injury of tibial nerve at lower leg level, unspecified leg, initial encounter
S84.01XA Injury of tibial nerve at lower leg level, right leg, initial encounter
S84.02XA Injury of tibial nerve at lower leg level, left leg, initial encounter
S84.10XA Injury of peroneal nerve at lower leg level, unspecified leg, initial encounter
S84.11XA Injury of peroneal nerve at lower leg level, right leg, initial encounter
S84.12XA Injury of peroneal nerve at lower leg level, left leg, initial encounter
S84.20XA Injury of cutaneous sensory nerve at lower leg level, unspecified leg, initial encounter
S84.21XA Injury of cutaneous sensory nerve at lower leg level, right leg, initial encounter
S84.22XA Injury of cutaneous sensory nerve at lower leg level, left leg, initial encounter
S84.801A Injury of other nerves at lower leg level, right leg, initial encounter
S84.802A Injury of other nerves at lower leg level, left leg, initial encounter
S84.809A Injury of other nerves at lower leg level, unspecified leg, initial encounter
S84.90XA Injury of unspecified nerve at lower leg level, unspecified leg, initial encounter
S84.91XA Injury of unspecified nerve at lower leg level, right leg, initial encounter
S84.92XA Injury of unspecified nerve at lower leg level, left leg, initial encounter
S94.00XA Injury of lateral plantar nerve, unspecified leg, initial encounter
S94.01XA Injury of lateral plantar nerve, right leg, initial encounter
S94.02XA Injury of lateral plantar nerve, left leg, initial encounter
S94.10XA Injury of medial plantar nerve, unspecified leg, initial encounter
S94.11XA Injury of medial plantar nerve, right leg, initial encounter
S94.12XA Injury of medial plantar nerve, left leg, initial encounter
S94.20XA Injury of deep peroneal nerve at ankle and foot level, unspecified leg, initial encounter
S94.21XA Injury of deep peroneal nerve at ankle and foot level, right leg, initial encounter
S94.22XA Injury of deep peroneal nerve at ankle and foot level, left leg, initial encounter
S94.30XA Injury of cutaneous sensory nerve at ankle and foot level, unspecified leg, initial encounter
S94.31XA Injury of cutaneous sensory nerve at ankle and foot level, right leg, initial encounter
S94.32XA Injury of cutaneous sensory nerve at ankle and foot level, left leg, initial encounter
S94.8X1A Injury of other nerves at ankle and foot level, right leg, initial encounter
S94.8X2A Injury of other nerves at ankle and foot level, left leg, initial encounter
S94.8X9A Injury of other nerves at ankle and foot level, unspecified leg, initial encounter
S94.90XA Injury of unspecified nerve at ankle and foot level, unspecified leg, initial encounter
S94.91XA Injury of unspecified nerve at ankle and foot level, right leg, initial encounter
S94.92XA Injury of unspecified nerve at ankle and foot level, left leg, initial encounter
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ICD-10-CM Codes that DO NOT Support Medical Necessity

Group 1

Group 1 Paragraph

All those not listed under the “ICD-10-CM Codes that Support Medical Necessity” section of this article. 

Group 1 Codes

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ICD-10-PCS Codes

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Group 1 Paragraph

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Group 1 Codes

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Additional ICD-10 Information

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Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

Code Description
011x Hospital Inpatient (Including Medicare Part A)
012x Hospital Inpatient (Medicare Part B only)
013x Hospital Outpatient
083x Ambulatory Surgery Center
085x Critical Access Hospital
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Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

Note: The contractor has identified the Bill Type and Revenue Codes applicable for use with the CPT/HCPCS codes included in this article. Providers are reminded that not all CPT/HCPCS codes listed can be billed with all Bill Type and/or Revenue Codes listed. CPT/HCPCS codes are required to be billed with specific Bill Type and Revenue Codes. Providers are encouraged to refer to the CMS Internet-Only Manual (IOM) Publication 100-04, Medicare Claims Processing Manual, for further guidance.


Code Description
036X Operating Room Services - General Classification
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Other Coding Information

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Group 1 Codes

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Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
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Non-Excluded CPT/HCPCS Ended Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
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Revision History Information

Revision History Date Revision History Number Revision History Explanation
04/20/2023 R3

Article revised and published on 04/20/2023 to delete CPT code 95941 and replace with HCPCS code G0453 in the ‘Coding Guidance’ section.

10/01/2022 R2

Article revised and published on 10/20/2022 effective for dates of service on and after 10/01/2022 to reflect the Annual ICD-10-CM Code Updates. The following ICD-10-CM codes have been deleted and therefore have been removed from the ICD-10-CM Codes that Support Medical Necessity Group 1: I71.01; I71.1; I71.2; I71.3; I71.4; I71.5; I71.6. The following ICD-10-CM codes have been added to the ICD-10-CM Codes that Support Medical Necessity Group 1: I71.010; I71.011; I71.012; I71.11; I71.12; I71.13; I71.21; I71.22; I71.23; I71.31; I71.32; I71.33; I71.41; I71.42; I71.43; I71.51; I71.52; I71.61; I71.62. Minor formatting changes have been made throughout the article.

11/14/2019 R1

Due to system changes the order of the Coding Section has been revised and new sections for CPT/HCPCS Modifiers and Other Coding Information have been added.

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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related Local Coverage Documents
LCDs
L35003 - Intraoperative Neurophysiological Testing
Related National Coverage Documents
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SAD Process URL 1
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SAD Process URL 2
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Statutory Requirements URLs
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Rules and Regulations URLs
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CMS Manual Explanations URLs
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Other URLs
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Public Versions
Updated On Effective Dates Status
10/20/2023 10/01/2023 - N/A Currently in Effect View
04/14/2023 04/20/2023 - 09/30/2023 Superseded You are here
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

Keywords

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