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Medicare acceptable Diagnosis

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Patient Name

Date

THORACIC

CERVICAL

ICD-10 DIAGNOSIS CHART

LUMBAR

Seg Dysfx Head M99.00

Seg Dysfx Neck M99.01

Medicare Cat 1 (1-6 tx)

Spondylosis (back pain OA) w/ Rad

-OA C0-1-2 M47.21

-Cervical M47.22

Spondylosis (Age related OA) w/o Rad

-OA C0-1-2 M47.811

-Cervical M47.812

DISH

-C0-1-2 M48.11

-Cervical M48.12

Cervicalgia M54.2

Headache cervicogenic (gen) R51

Tension headache G44.209

Episodic Tension Headache G44.219

Chronic tension Headache G44.229

Vascular Headache G44.1

Category 2 Medicare DX (7-12 tx)

Neck Sprain Lig.’s S13.4XXA

Neck muscle/tendon/ S16.1XXA

Neck Joints & other S13.8XXA

Brachial thoracic outlet synd. G54.0

Cervical Radiculopathy G54.2

Joint Pain M25.50

Spondylolisthesis C0-2 M43.11

Spondylolisthesis C3-6 M43.12

Fusion C0-2 M43.21

Fusion C3-6 M43.22

Spinal Tendinitis C0-2 M46.01

Spinal Tendinitis C3-6 M46.02

Stenosis C0-2 M48.01

Stenosis C3-6 M48.02

IVD Disorder w/ Rad C0-2 M50.11

IVD Disorder w/ Rad C3-6 M50.12

Other IVD C0-1 M50.81

Other IVD C3-6 M50.82

Cervicocranial Syndrome M53.0

Cervicobrachial Syndrome M53.1

Radiculopathy C0-2 M54.11

Radiculopathy C3-6 M54.12

Muscle Spasms of Back M62.830

Myalgia M79.1

Fibromyalgia M79.7

Stenosis of Neural Canal

-Subluxation Neck M99.21

-Osseous Neck M99.31

-Connective Tissue Neck M99.41

-IVD Neck M99.51

Intervertebral Foramina Stenosis

-Osseous & Subluxation CS M99.61

-Connective Tissue & Disc CS M99.71

Category 3 Medicare DX (12-24 tx)

IVD Disorder W/O C0-2 M50.21

IVD Disorder W/O C3-6 M50.22

Disc Degn. C0-2 M50.31

Disc Degn. C3-6 M50.32

Disc Degn. C7-T1 M50.33

Postlaminectomy synd M96.1

Traumatic Spondylopathy (disease)

-C0-2 M48.31

-C3-6 M48.32

Seg. Dysfx. M99.02

Medicare Cat 1 (1-6 tx)

Spondylosis (back pain OA) w/ Rad

-Thoracic M47.24

-Cervcothoracic M47.23

Spondylosis (Age related OA) w/o Rad

-Thoracic M47.814

-Cervcothoracic M47.813

DISH

-Cervcothoracic M48.13

-Thoracic M48.14

-Thoracic spine pain M54.6

Category 2 Medicare DX (7-12 tx)

Thoracic Sprain S23.3XXA

Thoracic other Sp/St S23.8XXA

Thoracic Radiculopathy G54.3

Joint Pain M25.50

Spondylolisthesis C7-T1 M43.13

Spondylolisthesis T2-T11 M43.14

Fusion C7-T1 M43.23

Fusion T2-T11 M43.24

Spinal Tendinitis C7-T1 M46.03

Spinal Tendinitis T2-T11 M46.04

Stenosis C7-T1 M48.03

Stenosis T2-T11 M48.04

IVD Disorder w/ RadC7-T1 M51.13

IVD Disorder w/ RadT2-11 M51.14

Other IVD C7-T1 M50.83

Other IVD T2-11 M51.84

Radiculopathy C7-T1 M54.13

Radiculopathy T2-12 M54.14

Myalgia M79.1

Fibromyalgia M79.7

Stenosis of Neural Canal

-Subluxation Thoracic M99.22

-Osseous Thoracic M99.32

-Connective Tissue Thoracic M99.42

--IVD Thoracic M99.52

Intervertebral Foramina Stenosis

-Osseous & Subluxation TS M99.62

-Connective Tissue & Disc TS M99.72

Category 3 Medicare DX (12-24 tx)

IVD Disorder W/O C7-T1 M50.23

IVD Disorder W/O T2-11 M51.24

Disc Degn. T2-11 M51.34

Disc Degn. T12-L1 M51.35

Postlaminectomy synd M96.1

Traumatic Spondylopathy (disease)

-C7-T1 M48.33

-T1-T11 M48.34

Pelvis Sacrum Coccyx

Seg Dysfx Sacrum M99.04

Seg Dysfx hip, pelvis M99.05

Medicare Cat 1 (1-6 tx)

Spondylosis (back pain OA) w/ Rad

Lumbosacral M47.27

Sacral-Coccyx M47.28

Spondylosis (Age related OA) w/o Rad

Lumbosacral M47.27

Sacral-Coccyx M47.818

DISH

Lumbosacral M48.17

Sacral & Sacrococcygeal M48.18

Category 2 Medicare DX (7-12 tx)

Sacroiliac Sprain S33.6XXA

Sacroiliac Sp/St other S33.8XXA

Joint Pain M25.50

Spondylolisthesis L5-S1 M43.17

Spondylolisthesis Sac/Coccyx M43.18

Fusion L5-S1 M43.27

Fusion Sac-Coccyx M43.28

Spinal Tendinitis L5-S1 M46.07

Spinal Tendinitis Sac-Cocyx M46.08

Stenosis lumbosacral M48.07 Myalgia M79.1

Fibromyalgia M79.7

IVD Disorder w/Rad L5-S1 M51.17

Other IVD L5-S1 M50.87

Sacrococcygeal Instability M53.2X8

Radiculopathy L5-S1 M54.17

Category 3 Medicare DX (12-24 tx)

IVD Disorder W/O L5-S1 M51.27

Disc Degn. L5-S1 M51.37

Traumatic Spondylopathy (disease)

-L5-S1 M48.37

-Sacrococcygeal M48.38

Seg. Dysfx* M99.03

Medicare Cat 1 (1-6 tx)

Spondylosis (back pain OA) w/ Rad

Lumbar M47.26

Thoracolumbar M47.25

Spondylosis (Age related OA) w/o Rad

Thoracolumbar M47.815

Lumbar M47.16 DISH

Thoracolumbar M48.15

Lumbar M48.16

Low Back Pain M54.5

Category 2 Medicare DX (7-12tx)

Lumbar Sprain S33.5XXA

Lumbar other Sp/St S33.8XXA

Lumbosacral plx dis vasc G54.1

Lumbosacral Radiculopathy G54.4

Joint Pain M25.50

Spondylolisthesis T12-L1 M43.15

Spondylolisthesis L2-L4 M43.16

Fusion T12-L1 M43.25

Fusion L2-L4 M43.26

Spinal Tendinitis T12-L1 M46.05

Spinal Tendinitis L2-L4 M46.06

Stenosis T12-L1 M48.05

Stenosis L2-L4 M48.06 IVD Disordr w/RadT12-L1 M51.15

IVD Disordr w/Rad L2-L4 M51.16 Other IVD T12-L1 M50.85

Other IVD C7-T1 M50.86

Lumbosacral Instability M53.2X7

Radiculopathy T12-L1 M54.15

Radiculopathy L2-4 M54.16

Myalgia M79.1

Fibromyalgia M79.7

Stenosis of Neural Canal

-Subluxation Lumbar M99.23

-Osseous Lumbar M99.33

-Connective Tissue Lumbar M99.43

-IVD Lumbar M99.53

Intervertebral Foramina Stenosis

-Osseous & Subluxation LS M99.63

-Connective Tissue & Disc LS M99.73

Category 3 Medicare DX (12-24 tx)

IVD Disorder W/O T12-L1 M51.25 IVD Disorder W/O L2-L4 M51.26

Disc Degn. L2-L4 M51.36

Sciatica Right M54.31

Sciatica Left M54.32

Lumbago w/ Sciatica Right M54.41

Lumbago w/ Sciatica Left M54.42

Postlaminectomy synd M96.1

Traumatic Spondylopathy (disease)

-T12-L1 M48.35

-L2-L4 M48.36

Free conversion website



To Adjust Extremities use Myositis and Segmental Dysfunction DX

Shoulder R/L M60.811/2 Thigh R/L M60.851/2

Upper Arm R/L M60.821/2 Lower leg M60.861/2

Forearm R/L M60.831/2 Ankle M60.871/2

Hand R/L M60.841/2

Medicare Acceptable Diagnosis

Category 1(1-6 visits) Category 2 (6-12 visits) Category 3 (12-24 visits)

Must include segmental dysfunction and lead w/ highest category DX 1st

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