M25.78 identifies osteophyte formation specifically at the vertebrae — bony projections that develop along vertebral end plates or facet joints as a result of degenerative joint changes.
Verified May 8, 2026 · 5 sources ↓
- Status
- Billable
- Chapter
- 13
- Related CPT
- 20
- Region
- Spine
Documentation tips
What should appear in the chart to support M25.78.
Source · Editorial brief grounded in 5 cited references ↓
- Specify the vertebral region (cervical, thoracic, lumbar, sacral) in the clinical note — M25.78 has no level-specific subcode, but auditors and payers expect the region to appear in the record.
- Reference the imaging modality that identified the osteophyte (X-ray, CT, MRI) and note the specific finding: end-plate spur, anterior osteophyte, posterior osteophyte, or facet-margin osteophyte.
- Document whether the osteophyte is symptomatic — causing pain, radiculopathy, myelopathy, or cord/root compression — so sequencing between M25.78 and a primary neurological or structural code is defensible.
- If the osteophyte contributes to foraminal or central canal stenosis, code the stenosis separately (e.g., M48.06, M48.07) and list M25.78 as an additional code to reflect the full clinical picture.
- When conservative treatment has failed and surgical intervention is planned, document the osteophyte's role in the surgical indication to support medical necessity for decompression or fusion procedures.
Related CPT procedures
Procedure codes commonly billed with M25.78. Linking the right diagnosis to the right procedure is what establishes medical necessity.
Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis
Common coding pitfalls
The recurring mistakes coders make with M25.78 and adjacent codes.
Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓
- Using M25.78 as the sole code when spondylosis with radiculopathy or myelopathy is the documented primary condition — the M47.x spondylosis codes often include osteophyte as an inherent component and may be the more specific code.
- Omitting the vertebral region from documentation and relying on M25.78 alone, which gives payers no spinal-level context and can trigger medical necessity denials for level-specific procedures.
- Confusing M25.78 with M25.70 (osteophyte, unspecified joint) — if the vertebral location is documented, M25.78 is always the correct choice over the unspecified parent.
- Failing to code associated neurological deficits (radiculopathy, myelopathy, stenosis) as primary or co-primary diagnoses when they drive the encounter, leaving M25.78 incorrectly sequenced as the principal diagnosis.
Clinical context
Source · Editorial summary grounded in 5 cited references ↓
Use M25.78 when imaging or clinical documentation confirms osteophyte formation at one or more vertebral levels and no more specific spinal degeneration code fully captures the finding. The code applies across all vertebral regions (cervical, thoracic, lumbar, sacral) because M25.78 carries no level-specific subclassification — the spinal region is captured in the operative or diagnostic report narrative, not in the code itself.
M25.78 frequently appears alongside spondylosis codes (M47.x), degenerative disc disease codes, or radiculopathy codes when osteophytes are identified as a contributing structural finding. It can be listed as a secondary diagnosis when the primary reason for the encounter is nerve root compression, spinal stenosis, or cervical/lumbar myelopathy, and the osteophyte is documented as a causative or complicating factor.
This code groups to MS-DRG 551 (Medical back problems with MCC) or 552 (Medical back problems without MCC) under MS-DRG v43.0. When the encounter involves surgical intervention such as anterior cervical discectomy and fusion or lumbar decompression, M25.78 may serve as a supporting diagnosis alongside the primary procedural indication code.
Sibling codes
Other billable codes under M25.7 (laterality / anatomic variants).
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 5 cited references ↓
01Does M25.78 specify which vertebral level the osteophyte is at?
02Should I use M25.78 or a spondylosis code (M47.x) when both apply?
03Can M25.78 be the principal diagnosis for a surgical encounter?
04What MS-DRGs does M25.78 map to?
05Is M25.78 valid for cervical osteophytes causing dysphagia?
06Can M25.78 be used with spinal injection CPT codes?
07Are there any Excludes1 or Excludes2 notes I need to watch at the M25.78 level?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01CDC ICD-10-CM Tabular List 2026 (effective October 1, 2025)
- 02icd10data.comhttps://www.icd10data.com/ICD10CM/Codes/M00-M99/M20-M25/M25-/M25.78
- 03aapc.comhttps://www.aapc.com/codes/icd-10-codes/M25.78
- 04cms.govhttps://www.cms.gov/medicare/coding-billing/icd-10-codes
- 05cms.govhttps://www.cms.gov/medicare/coding/icd10/downloads/icd10clinicalconceptsorthopedics1.pdf
Mira AI Scribe
Mira's AI scribe captures the vertebral region, imaging modality, osteophyte morphology (anterior, posterior, end-plate, facet), and any associated neurological symptoms documented during the encounter. That detail supports correct sequencing between M25.78 and any co-coded spondylosis, stenosis, or radiculopathy code — preventing a medical necessity denial from payers who require explicit anatomical and symptom linkage.
See how Mira captures M25.78 documentation