DIAGNONIS CODES – MEDICARE



MASTER DIAGNOSIS SHEET – MEDICARE

Patient’s Name: _______________________________________________________ Date: __________________

PRIMARY ICD-9 Dx Codes Names of Vertebra

739.0 Occipitocervical (Occ-C1)

739.1 Cervical (C1-C7)

739.1 C1 (Atlas)

739.1 C2 (Axis)

739.2 Dorsal (D1-D12) or

739.2 Thoracic (T1-T12)

739.3 Lumbar (L1-L5)

739.4 Sacrococcygeal (S)

5. Pelvis

SECONDARY ICD-9 Diagnosis

Category III- ICD-9 (diagnoses that may require longer term treatment):

721.7 Traumatic spondylopathy

722.0 Displacement of cervical intervertebral disc without myleopathy

722.10 Displacement of lumbar intervertebral disc without myleopathy

722.11 Displacement of thoracic intervertebral disc without myelopathy

722.4 Degeneration of cervical intervertebral disc

722.51 Degeneration of thoracic or thoracolumbar intervertebral disc

52. Degeneration of lumbar or lumbrosacral intervertebral disc

722.6 Degeneration of invertebral disc, unspecified site

722.81 Post laminectomy syndrome, cervical region

733.82 Post laminectomy syndrome, thoracic region

722.83 Post laminectomy syndrome, lumbar region

724.3 Sciatica

Current Diagnosis:

1. _______________ 5. _______________

2. _______________ 6. _______________

3. _______________ 7. _______________ DC Signature __________________________________

4. _______________ 8. _______________ Date: _______________________________

Update Diagnosis

1. _______________ 5. _______________

2. _______________ 6. _______________

3. _______________ 7. _______________ DC Signature __________________________________

4. _______________ 8. _______________ Date: _______________________________

Category II- ICD-9 Diagnosis (diagnoses that generally require moderate term treatment):

353.0 Brachial plexus lesions

353.1 Lumbrosacral plexus lesions

353.2 Cervical root lesions, NEC

353.3 Thoracic root lesions, NEC

353.4 Lumbrosacral root lesions, NEC

353.8 Other nerve root and plexus disorders

719.48 Pain in joint (other specified sites) (must specify spine)

720.1 Spinal enthesopathy

722.91 Other and unspecified disc disorder, cervical region

722.92 Other and unspecified disc disorder, thoracic region

722.93 Other and unspecified disc disorder, Lumbar region

723.0 Spinal stenosis in cervical region

723.2 Cervicocranial syndrome

723.3 Cervicobrachial syndrome

723.4 Brachial neuritis or radiculitis

723.5 Torticollis, unspecified

724.01 Spinal stenosis, thoracic region

724.02 Spinal stenosis, lumbar region

724.4 Thoracic or lumbrosacral neuritis or radiculitis

724.6 Disorders of sacrum, ankylosis

724.79 Disorders of coccyx, coccygodynia

724.8 Other symptoms referable to back, facet syndrome

729.1 Myalgia and myositis, unspecified

729.4 Fasciitis, unspecified

738.40 Acquired spondylolisthesis

756.12 Spondylolisthesis

846.0 Sprains & strains of sacroiliac region, lumbosacral (joint;ligament)

846.1 Sprains & strains of sacroiliac region, sacroiliac ligament

846.2 Sprains & strains of sacroiliac region, sacrospinatus (ligament)

846.3 Sprains & strains of sacroiliac region, sacrotuberous (ligament)

846.8 Sprains & strains of sacroiliac region, other specified sites of sacroiliac region

847.0 Sprains & Strains of other and unspecified parts of back, neck

847.1 Sprains & Strains of other and unspecified parts of back, thoracic

847.2 Sprains & Strains of other and unspecified parts of back, lumbar

847.3 Sprains & Strains of other and unspecified parts of back, sacrum

847.4 Sprains & Strains of other and unspecified parts of back, coccyx

Category I-ICD-9 Diagnosis (diagnoses that generally require short term treatment):

81. Tension headache

48. Contracture joint (fixation, spine only)

721.0 Cervical spondylosis without myelopathy

721.2 Thoracic spondylosis without myelopathy

3. Lumbosacral spondylosis without myelopathy

721.6 Ankylosing vertebral hyperostosis

721.90 Spondylosis of unspecified site without myelopathy

721.91 Spondylosis of unspecified site with myelopathy

723.1 Cervicalgia

724.1 Pain in thoracic spine

724.2 Lumbago

724.5 Backache, unspecified

784.0 Headache

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