ICD-10 Code M54.12
What is the code M54.12?
M54.12 is a billable/specific ICD-10-CM code used to denote "Radiculopathy, cervical region." This code falls under the chapter of diseases of the musculoskeletal system and connective tissue, specifically category M54 Dorsalgia. It is used in clinical settings for documentation and billing purposes and specifies that the radiculopathy is located in the cervical (neck) area of the spine.
Detailed description of M54.12
The diagnosis of cervical radiculopathy involves nerve pain caused by compression or irritation of nerves in the cervical spine. This condition typically presents with pain that may radiate from the neck into the shoulder, arm, hand, or fingers and can be accompanied by numbness or weakness in these areas.
Symptoms commonly associated with M54.12
Patients with cervical radiculopathy may experience:
- Pain that radiates from the neck down into the arm or fingers
- Numbness or tingling in the arms or hands
- Weakness in the muscles of the arm, shoulder, or hand
- Neck pain, especially when turning the head
- Loss of sensation or reflexes in the arms or shoulders
Related and similar ICD-10-CM codes
- M54.10 (Radiculopathy, site unspecified): Used when the radiculopathy location is not specified.
- M54.13 (Radiculopathy, cervicothoracic region): Specifies radiculopathy that affects both the cervical and upper thoracic regions. These codes help to classify radiculopathy based on the specific region of the spine affected.
Appropriate usage of M54.12 for billing
M54.12 should be used for billing purposes when a provider lists in the assessment portion of their note that a patient is diagnosed with radiculopathy, specifically in the cervical region.
Alternative term that is coded as M54.12 is “Cervical radiculitis.”
Instructional guidelines for providers coding M54.12
For coding with ICD-M54.12, cervical radiculopathy, it is encouraged to include documentation of the diagnostic criteria met, the symptoms observed and any supporting imaging studies in the assessment portion of the medical note. While comprehensive documentation of symptoms, diagnostic test results, and clinical findings supports the use of M54.12, it is not necessary for physician billing.
Subcategory M54.1 Radiculopathy includes a type 1 excludes note for M54.12, which advises against using this code in conjunction with:
- Radiculopathy with cervical disc disorder (M50.1)
- Radiculopathy with spondylosis (M47.2-)
If a patient is diagnosed with a cervical disc disorder or cervical spondylosis, only the appropriate code from the excludes note should be assigned, and M54.12 should be omitted. This guideline ensures the accuracy and specificity of the coding process.
Common pitfalls in coding with M54.12
- Incorrectly coding for cervical radiculopathy when the symptoms may be due to another condition affecting the cervical spine.
- Failing to document the specific symptoms and diagnostic findings that confirm the location and nature of the radiculopathy.
Key resources for M54.12 coding
- CMS ICD-10 Homepage: Provides official resources and guidelines for ICD-10-CM coding.
- WHO ICD-10 Online Browser: Useful for verifying ICD-10-CM codes and understanding their criteria.
Conclusion
The ICD-10-CM code M54.12 is used for accurately documenting cases of cervical radiculopathy. Proper application of this code supports effective patient management, ensuring that individuals receive appropriate interventions as well as ensuring compliance with healthcare reporting requirements.
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