Chiropractic ICD-10 codes are essential for recording diagnoses, symptoms, and procedures for every patient encounter. Not just for record purposes, ICD-10 codes (International Classification of Diseases, Tenth Revision) also play a crucial role in chiropractic billing and reimbursements. Coding errors often result in claim denials. That’s why using valid diagnoses codes can facilitate better claims payments and support the medical necessity of the service in case of review or audits.

There are over 70,000 ICD-10 codes within the fiscal year 2024, with 395 new ICD-10 codes added, 25 codes removed, and 22 existing ones altered in the 2024 ICD-10 code update. To help you navigate the complexities of coding, we’ve compiled this ICD-10 codes chiropractic cheat sheet that covers all the diagnoses codes used for different musculoskeletal diseases.

Use this common ICD-10 codes cheat sheet as a guide for coding. It is not intended to represent all ICD-10 codes accepted by insurance payers.

Migraine

A migraine can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It’s often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. The table below includes the most commonly used chiropractic ICD-10 codes for migraines:

Type 1 Excludes for Migraine Codes

• headache NOS (R51.9)
• lower half migraine (G44.00)

Type 2 Excludes for Migraine Codes

• headache syndromes (G44.-)

Back Pain

Back pain is a common reason for seeking chiropractic treatment. It can be uncomfortable and debilitating. People of all ages can experience back pain for various reasons. Pain in the upper back can be caused by disorders of the aorta, ad inflammation of the spine and other reasons. Lower back pain may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, and abdominal and pelvic internal organs.

The table below includes the most commonly used ICD-10 chiropractic codes for back pain:

Cervical Pain Disorders

Cervicalgia, commonly known as neck pain, is a prevalent issue, affecting two-thirds of the population at some point in their lives. Some of the synonyms for cervical pain:

• Neck pain
• Acute neck pain (less than 3 months)
• Chronic neck pain
• Pain in cervical spine (less than 3 months)
• Pain in cervical spine (more than 3 months)
• Acute pain in cervical spine (less than 3 months)
• Chronic pain in cervical spine (more than 3 months)
• Chronic neck pain (greater than 3 months)

The table below includes the most commonly used  ICD-10 chiropractic codes for Cervical Pain Disorders:

Sciatica

Sciatica (also referred to as lumbar radiculopathy) is a condition characterized as an injury to the sciatic nerve. The sciatic nerve begins at your hip and runs through the leg to knee. Conditions like herniated discs, degenerative disc disease, spinal stenosis, foraminal stenosis, spondylolisthesis, osteoarthritis, and other diseases could cause sciatica.

Here are the commonly used ICD-10 codes for sciatica based on the degree of specificity you can identify.

Radiculopathy 

M54.12 is a specific ICD-10-CM code used for classifying and documenting Radiculopathy in the Cervical Region.

Here are the commonly used ICD-10 chiropractic codes for radiculopathy based on the degree of specificity you can identify.

Synonyms Include

• Cervical radiculopathy
• Cervical nerve root compression
• Cervical nerve root irritation
• Cervical nerve root disorder
• Cervical radicular syndrome

Sprains and Strains  

A sprain happens when direct or indirect trauma (such as a fall or a blow to the body) dislocates a joint from its normal position, overstretching or even tearing the supporting ligaments in severe cases. Chronic strains are caused by prolonged, repetitive movement of muscles and tendons.

 ICD-10 has several codes in the sprains and strains category, depending upon the exact location and episode of care.

Spondylosis

Spondylosis is a degenerative condition that may cause potential loss of normal spine structure and function. Making a correct diagnosis of spondylosis involves checking the affected nerves, bones, and muscles, and testing the movement of the affected parts.

Chiropractic ICD-10 codes used to indicate a diagnosis of spondylosis include:

Conclusion

Chiropractic diagnosis codes used in patient documentation should accurately represent neuromusculoskeletal (NMS) conditions and the specific body regions that require treatment. The primary ICD-10 codes used for the treatment should be in the first position on the claim form. You should also use secondary, tertiary, and quaternary ICD-10 codes to report any additional conditions or regions being treated.

This chiropractic billing cheat sheet, offering commonly used ICD-10 codes, will serve as a valuable resource to streamline your billing and coding processes and ensure accurate documentation. By leveraging these codes effectively, your biller can enhance billing efficiency, facilitate smoother claims processing, and ultimately optimize revenue management.

[Read: The Complete Guide To Chiropractic Billing]

Chiropractic billing is complicated. If you process high volumes of claims on a daily basis, outsourcing your billing process will help you focus on what matters most – your patients. Billing specialists at zHealth will take care of your codes, claims, appeals, denials, A/R, and other billing works. To learn more about how zHealth’s chiropractic billing services can help you get paid faster, request a free billing analysis.

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