ICD Code M51.361

ICD code M51.361 is used to identify a medical condition characterized by the degeneration of intervertebral discs specifically in the lumbar region of the spine, which is the lower back area. This degeneration is associated with pain that is experienced only in the lower extremities, such as the legs. This code helps healthcare providers accurately document and communicate the specific nature of the patient's condition for purposes such as treatment planning, billing, and insurance claims.

When to use the ICD code M51361:

1. Diagnosis of Intervertebral Disc Degeneration
- Confirmed diagnosis of other intervertebral disc degeneration in the lumbar region.

2. Presence of Lower Extremity Pain
- Patient reports pain localized to the lower extremities, such as the legs or feet.

3. Exclusion of Other Causes
- Other potential causes of lower extremity pain have been ruled out through clinical evaluation and diagnostic imaging.

4. Chronicity of Symptoms
- Symptoms have been persistent or recurrent over a specified duration, typically more than three months.

5. Functional Impact
- The lower extremity pain is affecting the patient's daily activities or quality of life.

6. Neurological Symptoms (if applicable)
- Presence of neurological symptoms such as numbness, tingling, or weakness in the lower extremities, indicating possible nerve involvement.

7. Response to Conservative Treatment
- The patient has not responded adequately to conservative treatment options, such as physical therapy or medication.

8. Documentation of Symptoms
- Comprehensive documentation of the patient's symptoms, including onset, duration, and severity, is available in the medical record.

9. Follow-Up Evaluations
- Regular follow-up evaluations indicate persistence of symptoms related to intervertebral disc degeneration.

10. Patient History
- Relevant patient history, including previous spinal issues or surgeries, is documented and considered in the diagnosis.

Utilizing the ICD code M51361 is appropriate when these diagnostic criteria and symptoms are met, ensuring accurate coding and billing in the healthcare revenue cycle management process.

For the ICD code M51.361, which pertains to other intervertebral disc degeneration in the lumbar region with lower extremity pain only, the relevant CPT codes that may be applicable for treatment include:

1. CPT 62323 - Injection(s), of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (e.g., fluoroscopy or CT).

2. CPT 64483 - Injection(s), anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, single level.

3. CPT 64635 - Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint.

4. CPT 22551 - Arthrodesis, anterior interbody, including minimal discectomy to prepare interspace (other than for decompression); lumbar.

5. CPT 63030 - Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar.

6. CPT 22853 - Insertion of interbody biomechanical device(s) (e.g., synthetic cage, mesh) with integral anterior instrumentation for device anchoring (e.g., screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace.

These CPT codes are examples of procedures that may be considered for the treatment of conditions associated with ICD code M51.361. It is important for healthcare providers to select the appropriate CPT code based on the specific treatment plan and clinical scenario for each patient.

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