There are two categories to choose from for spinal disc disorders:

      M50- CERVICAL DISC DISORDERS

      M51- THORACIC, THORACOLUMBAR, AND LUMBOSACRAL INTERVERTEBRAL DISC DISORDERS

Each one has the same fourth character options:

      0= disc disorder with myelopathy

      1= disc disorder with radiculopathy

      2= other disc displacement

      3= other disc degeneration

      4= Schmorl’s nodes (not available for the cervical region)

      8= other disc disorders

      9= unspecified disc disorder

The fifth character provides detail about the anatomical location within that spinal region.

Here are a couple of tips to keep in mind when using these codes:

♦ It may be helpful to consider that “disc disorders” include protrusions, bulges, and herniation, and this is the term used for the fourth characters “0” or “1”. “Disc displacement” for the fourth character “2” also could include those things, but it does not include cord or nerve root complications.

♦ Don’t code radiculitis (M54.1-) separately if you use the fourth character of “1”, “with radiculopathy”, for the disc disorders (M50.1- or M51.1-). It is already included in the code. Likewise don’t code sciatica (M54.3-) if you code for lumbar disc with radiculopathy. It would be redundant. On a side note, lumbar radiculopathy (M54.16) might be used if the pain is not known yet to be due a disc but it does radiates from the lumbar spine. The same condition, without confirmation of a disc, might be coded as sciatica (M54.3-) instead if it radiates all the way to the back of the leg.

♦ Don’t code cervicalgia (M54.2) along with the cervical disc disorders (M50-), and don’t code low back pain (M54.5) along with lumbar disc displacement (M51.2-). Those symptoms are included with the more definitive disc diagnoses.

♦ There is a strange rule for cervical disc disorders that says you should code to the most superior level of the disorder. It seems to imply that you would only code M50.11 if the problem occurs all throughout the neck. Official sources say that this rule may be clarified someday, so stay tuned.

♦ Only use the fourth character “8” for “other disc disorders” if none of the other fourth character choices fit. Consider all the others first. The official guidelines tell us that is how use “other specified” or “NEC” when we encounter it in a code description. If you can come up with a disc disorder that does not match one of the other choices, then this is the code for you.

♦ Only use the fourth character “9” for “unspecified disc disorders” if the documentation does not state anything more than there is a disc problem. But beware, payers are expected to ask for clarification if “unspecified” or “NOS” codes are used.

♦ The fifth character options include transitionary regions. “Cervicothoracic” is clearly designated as C7-T1. Though it is not specifically mentioned, “thoracolumbar” likely only includes T12-L1, and “lumbosacral” probably only refers to the L5-S1 interspace.