Updated September 16, 2024
The 2025 ICD-10-CM diagnosis code updates will be effective starting October 1, 2024. These updates include 252 new codes, 36 deletions, and 13 revisions. While the full list of changes impacts various medical disciplines, several codes are particularly relevant for chiropractic care, as they relate to conditions often treated by chiropractors. The 2025 updates include new codes for lumbar disc degeneration and changes to the codes for synovitis and tenosynovitis.
With these update, the Centers for Medicare & Medicaid (CMS) have updated their list of diagnostic codes considered medically necessary and payable for chiropractic services. To view this list of codes, go to the CMS’ Local Coverage Article (LCA) for Billing and Coding of Chiropractic Services. Please note that this list is utilized by Medicare Part B and most Medicare Advantage Plans (Part C). Commercial and other payers may utilize a different methodology for diagnostic codes.
Updated Codes for M51.36 and M51.37 Subcategories
The update adds codes to the subcategory, M51.36 (Other intervertebral disc degeneration, lumbar region) and M51.37 (Other intervertebral disc degeneration, lumbosacral region). These codes allow more accurate documentation of the patient’s symptoms and location of pain.
For the lumbar region, the new codes include:
- M51.360 – Lumbar region with discogenic back pain only
- M51.361 – Lumbar region with lower extremity pain only
- M51.362 – Lumbar region with discogenic back pain and lower extremity pain
- M51.369 – Lumbar region without mention of lumbar back pain or lower extremity pain
For the lumbosacral region, the new codes include:
- M51.370 – Lumbosacral region with discogenic back pain only
- M51.371 – Lumbosacral region with lower extremity pain only
- M51.372 – Lumbosacral region with discogenic back pain and lower extremity pain
- M51.379 – Lumbosacral region without mention of lumbar back pain or lower extremity pain
Updated Codes for Synovitis and Tenosynovitis (M65)
The update converts the existing M65.9 (Synovitis and tenosynovitis, unspecified) into a parent code. This change allows for the addition of more specific codes by appending sixth characters to indicate the exact location and laterality (left, right, or unspecified) of the condition.
Here is the new code structure for the M65.9 category:
Unspecified Site:
- M65.90 – Unspecified synovitis and tenosynovitis, unspecified site
- Specific Extremity Locations:
- Shoulder:
- M65.91 – Unspecified synovitis and tenosynovitis, shoulder
- M65.911 – Right shoulder
- M65.912 – Left shoulder
- Upper Arm:
- M65.92 – Unspecified synovitis and tenosynovitis, upper arm
- M65.921 – Right upper arm
- M65.922 – Left upper arm
- Forearm:
- M65.93 – Unspecified synovitis and tenosynovitis, forearm
- M65.931 – Right forearm
- M65.932 – Left forearm
- Hand:
- M65.94 – Unspecified synovitis and tenosynovitis, hand
- M65.941 – Right hand
- M65.942 – Left hand
- Thigh:
- M65.95 – Unspecified synovitis and tenosynovitis, thigh
- M65.951 – Right thigh
- M65.952 – Left thigh
- Lower Leg:
- M65.96 – Unspecified synovitis and tenosynovitis, lower leg
- M65.961 – Right lower leg
- M65.962 – Left lower leg
- Ankle and Foot:
- M65.97 – Unspecified synovitis and tenosynovitis, ankle and foot
- M65.971 – Right ankle and foot
- M65.972 – Left ankle and foot
- Other Sites:
- M65.98 – Unspecified synovitis and tenosynovitis, other site
- Multiple Sites:
- M65.99 – Unspecified synovitis and tenosynovitis, multiple sites
- Laterality Specification: The new codes require a sixth character to specify laterality:
- 1 – Right
- 2 – Left
- 9 – Unspecified
Resources:
- Centers for Medicare & Medicaid Services (CMS):
