Diagnosis Coding for Foraminal Stenosis

Diagnosis Coding for Foraminal Stenosis

May 9, 2019

Question:
I have a question regarding one of your previous Coding Coach Q&As that I recently saw.   The question is about coding stenosis.  Wouldn’t the code(s) for foraminal stenosis be M99.8 and then 5th digit based on the area of the spine?

Answer:
Actually, no.  Why? Because the guidelines just under the M99 heading say “This category should not be used if the condition can be classified elsewhere.”  Neurosurgeons can always find a more specific diagnosis such as M48.061 or even radiculopathy (M54.-).

*This response is based on the best information available as of 5/9/19.

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