MEDICARE DIAGNOSIS

ICD-9 CODES THAT SUPPORT MEDICAL NECESSITY


PRIMARY ICD-9 CODES (SUBLUXATION)
739.0 Occipitocervical (Occ-C1)739.1 Cervical (C1-C7)
739.1 C1 (Atlas)739.1 C2 (Axis)
739.2 Dorsal (D1-D12)739.2 Thoracic (T1-T12)
739.3 Lumbar (L1-L5)739.4 Sacrococcygeal (S)
739.5 Pelvis (P)


SECONDARY ICD-9 CODES
(NEUROMUSCULOSKELETAL Dx OR SYMPTOMS)

CATEGORY I   ICD-9 CODES
Diagnoses that generally require short term treatment:
307.81 Tension headache721.0 Cervical spondylosis w/o myelopathy
721.2 Thoracic spondylosis w/o myelopathy721.3 Lumbosacral spondylosis w/o myelopathy
721.90 Spondylosis of unspecified site w/o myelopathy723.1 Cervicalgia
724.1 Pain in thoracic spine724.2 Lumbago
724.5 Backache, unspecified784.0 Headache


CATEGORY II   ICD-9 CODES
Diagnoses that generally require moderate term treatment:
353.0 Brachial plexus lesions353.1 Lumbosacral plexus lesions
353.2 Cervical root lesions, NEC353.3 Thoracic root lesions, NEC
353.4 Lumbosacral root lesions, NEC353.8 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 region722.92 Other and unspecified disc disorder, thoracic region
722.93 Other and unspecified disc disorder, lumbar region723.0 Spinal stenosis in cervical region
723.2 Cervicocranial syndrome723.3 Cervicobrachial syndrome
723.4 Brachial neuritis or radiculitis, NOC723.5 Torticollis, unspecified
724.01 Spinal stenosis, thoracic region724.02 Spinal stenosis, lumbar region
724.4 Thoracic or lumbosacral neuritis or radiculitis724.6 Disorders of sacrum, ankylosis
724.79 Disorders of coccyx, coccygodynia724.8 Other symptoms referable to back, facet syndrome
729.1 Myalgia and myositis, unspecified729.4 Fascitis, unspecified
738.4 Acquired spondylolisthesis756.12 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 regions, sacrotuberous (ligament)
846.8 Sprains & strains of sacroiliac region, of 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 III   ICD-9 CODES
Diagnoses that may require longer term treatment:
721.7 Traumatic spondylopathy
722.0 Displacement of cervical intervetebral disc w/o myelopathy
722.10 Displacement of lumbar intervertebral disc w/o myelopathy
722.11 Displacement of thoracic intervertebral disc w/o myelopathy
722.4 Degeneration of cervical intervertebral disc
722.51 Degeneration of thoracic or thoracolumbar intervertebral disc
722.52 Degeneration of lumbar of lumbosacral intervertebral disc
722.81 Post laminectomy syndrome, cervical region
722.82 Post laminectomy syndrome, thoracic region
722.83 Post laminectomy syndrome, lumbar region
724.3 Sciatica

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