ICD Code M62.85

ICD code M62.85 is used to identify a medical diagnosis related to the dysfunction of the multifidus muscles in the lumbar region of the spine. The multifidus muscles are a group of small muscles located along the vertebral column, and they play a crucial role in stabilizing the spine and supporting posture. Dysfunction in these muscles can lead to lower back pain, reduced mobility, and other complications affecting the lumbar area. This code is utilized by healthcare providers to document and communicate this specific condition for purposes such as treatment planning, billing, and insurance claims within the healthcare revenue cycle management process.

When to use the ICD code for dysfunction of the multifidus muscles in the lumbar region, consider the following diagnostic criteria and symptoms:

1. Patient History
- Previous episodes of lower back pain or lumbar dysfunction.
- History of trauma or injury to the lumbar region.

2. Physical Examination Findings
- Palpable tenderness in the lumbar region, particularly over the multifidus muscles.
- Reduced range of motion in the lumbar spine.

3. Neurological Assessment
- Absence of neurological deficits, such as weakness or numbness in the lower extremities.
- Normal reflexes in the lower limbs.

4. Pain Characteristics
- Localized pain in the lumbar region, often exacerbated by movement or prolonged sitting.
- Pain that may radiate to the buttocks but does not extend below the knee.

5. Functional Limitations
- Difficulty with activities requiring lumbar stability, such as lifting, bending, or prolonged standing.
- Impairment in daily activities due to pain or discomfort in the lumbar area.

6. Imaging Studies
- MRI or CT findings indicating dysfunction or atrophy of the multifidus muscles without significant structural abnormalities in the lumbar spine.
- Exclusion of other lumbar pathologies, such as herniated discs or spinal stenosis.

7. Response to Treatment
- Lack of improvement with conservative treatments such as physical therapy or pain management.
- Symptoms persisting despite adherence to prescribed rehabilitation protocols.

These criteria should be carefully evaluated to determine the appropriate use of the ICD code for this condition.

For the ICD code M62.85, which pertains to dysfunction of the multifidus muscles in the lumbar region, the relevant CPT codes that may be applicable for treatment include:

1. 97110 - Therapeutic exercises to develop strength and endurance, range of motion, and flexibility.

2. 97112 - Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and proprioception.

3. 97140 - Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction).

4. 97530 - Therapeutic activities, direct (one-on-one) patient contact by the provider (use of dynamic activities to improve functional performance).

5. 20552 - Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s).

6. 20610 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa).

These CPT codes are often used in the context of physical therapy, rehabilitation, and pain management for conditions related to muscle dysfunction in the lumbar region. It is important for healthcare providers to select the appropriate CPT code based on the specific treatment or procedure performed.

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