ICD-10-CM · Spine

M41.47

Lateral spinal curvature originating from neuromuscular pathology, localized to the lumbosacral region of the spine.

Verified May 8, 2026 · 7 sources ↓

Status: Billable
Chapter: 13
Related CPT: 16
Region: Spine

Drawn from CDCICD10DataAAPCCMSClear-institute

Documentation tips

What should appear in the chart to support M41.47.

Source · Editorial brief grounded in 7 cited references ↓

Name the specific neuromuscular diagnosis driving the scoliosis (e.g., cerebral palsy, Friedreich's ataxia, poliomyelitis) — this is required for M41.4x and should be coded separately.
Record Cobb angle measurement from standing full-length PA spine radiograph, including the apex vertebra and end vertebrae of the curve.
Confirm that the primary curve apex or structural involvement is in the lumbosacral region; ambiguous curve location is an audit trigger.
Document whether the curve is progressive and include prior Cobb angle measurements when available — this supports medical necessity for bracing or surgical intervention.
If the patient has undergone prior spinal fusion, note instrumented levels and whether residual or adjacent-segment curvature remains.

Related CPT procedures

Procedure codes commonly billed with M41.47. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

22800 $1,312.99

Posterior spinal arthrodesis for deformity correction spanning up to 6 vertebral segments, with or without application of a body cast.

22802 $1,936.25

Posterior spinal arthrodesis for deformity correction spanning 7 to 12 vertebral segments, with or without body cast application.

22804 $2,222.50

Posterior spinal arthrodesis for deformity correction spanning 13 or more vertebral segments, performed with or without application of a body cast.

22840 $668.35

Posterior non-segmental instrumentation placed during spinal surgery, using rods, hooks, or wires that span multiple vertebral levels without anchoring at each intervening segment.

22842 $680.04

Posterior segmental spinal instrumentation spanning 3 to 6 vertebral segments, reported as an add-on to the primary spinal procedure code.

22843 $728.47

Posterior segmental spinal instrumentation spanning 7 to 12 vertebral segments, reported as an add-on to the primary fusion or decompression procedure.

22844 $875.10

Posterior segmental spinal instrumentation spanning 13 or more vertebral segments, reported as an add-on to the primary spinal procedure.

22845 $647.64

Anterior spinal instrumentation placed across 2 to 3 vertebral segments; reported as an add-on to the primary spinal procedure code.

22853 $228.80

Add-on code for inserting an interbody biomechanical device (e.g., synthetic cage or mesh) with integral anterior anchoring instrumentation into an intervertebral disc space, performed alongside interbody arthrodesis, reported once per interspace.

72100 $40.42

Radiologic examination of the lumbosacral spine capturing two or three views, used to evaluate the lumbar vertebrae and sacrum for injury, degeneration, or structural abnormality.

72110 $53.44

Radiologic examination of the lumbar spine (lumbosacral) with a minimum of four views, including oblique and/or bending views.

72114 $61.79

Radiologic examination of the lumbosacral spine, complete series with bending (flexion/extension) views — minimum of 6 views total.

97165 $100.54

Low-complexity occupational therapy evaluation, typically 30 minutes face-to-face, for patients with no comorbidities affecting occupational performance and a limited set of treatment options.

97167 $100.54

Occupational therapy initial evaluation at high complexity, involving extensive history review, assessment of five or more performance deficits, and high-analytic-complexity clinical decision-making — typically 60 minutes face-to-face.

97166 View procedure details

97530 View procedure details

Common coding pitfalls

The recurring mistakes coders make with M41.47 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

Using M41.57 (Other secondary scoliosis, lumbosacral) instead of M41.47 when the cause is a neuromuscular condition — these are distinct subcategories; neuromuscular etiology requires M41.4x.
Omitting the underlying neuromuscular condition code — M41.47 should not stand alone when the causative diagnosis (e.g., G80.x for cerebral palsy) is known and documented.
Assigning M41.47 when the curve apex is in the lumbar region only — use M41.46 if imaging places the structural curve above the lumbosacral junction.
Selecting M41.40 (site unspecified) when imaging clearly defines lumbosacral involvement — unspecified site codes invite payer scrutiny and undercoding.
Confusing thoracolumbar curves (M41.45) with lumbosacral curves (M41.47) — Cobb angle measurement and apex vertebra documentation resolve this distinction.

Clinical context

Source · Editorial summary grounded in 7 cited references ↓

M41.47 applies when a documented neuromuscular disorder — cerebral palsy, Friedreich's ataxia, poliomyelitis, or a comparable condition — is the direct underlying cause of scoliosis, and the primary curve is in the lumbosacral region. The neuromuscular etiology is what distinguishes this from idiopathic scoliosis (M41.1x) or other secondary scoliosis (M41.57). The underlying condition should be coded separately and sequenced according to the etiology/manifestation convention.

The lumbosacral designation (6th character 7) places the apex or primary structural involvement at the L5–S1 junction or spanning that transition. If imaging documents the primary curve higher — lumbar only — use M41.46. If the curve spans thoracic and lumbar segments, consider M41.45 (thoracolumbar). Do not use M41.47 for idiopathic or thoracogenic scoliosis regardless of curve location.

M41.47 groups into MS-DRGs 456–458 when associated with spinal fusion, and into DRGs 551–552 for medical management. It is recognized by CMS as a covered diagnosis for outpatient occupational therapy (A53064) and home health occupational therapy (A53057), and supports medical necessity for spinal orthoses under payer policies that cite the M40–M41.9 range.

Sibling codes

Other billable codes under M41.4 (laterality / anatomic variants).

M41.40

Neuromuscular scoliosis, site unspecified

M41.46

Neuromuscular scoliosis, lumbar region

M41.43

Neuromuscular scoliosis, cervicothoracic region

M41.45

Neuromuscular scoliosis, thoracolumbar region

M41.41

Neuromuscular scoliosis, occipito-atlanto-axial region

M41.44

Neuromuscular scoliosis, thoracic region

M41.42

Neuromuscular scoliosis, cervical region

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01What is the difference between M41.47 and M41.57?

M41.47 is for neuromuscular scoliosis specifically — caused by disorders such as cerebral palsy, Friedreich's ataxia, or poliomyelitis. M41.57 (Other secondary scoliosis, lumbosacral) is used when the scoliosis is secondary to a non-neuromuscular cause, such as leg length discrepancy. Never use M41.57 when the documented etiology is neuromuscular.

02Do I need to code the underlying neuromuscular condition separately?

Yes. The etiology/manifestation convention requires you to code the underlying neuromuscular disorder (e.g., G80.x for cerebral palsy, G11.1 for Friedreich's ataxia, B91 for sequelae of poliomyelitis) in addition to M41.47. The underlying condition code is typically sequenced first.

03How do I distinguish a lumbosacral curve (M41.47) from a lumbar curve (M41.46)?

Use the apex vertebra and the structural extent of the curve documented on imaging. If the curve is confined to the lumbar spine, use M41.46. If it involves or extends to the lumbosacral junction (L5–S1 segment), use M41.47. Document the specific vertebral levels to avoid a query.

04Is M41.47 valid for orthotic (back brace) medical necessity?

Yes. Payer policies that cover spinal orthoses for the M40.00–M41.9 range include M41.47, and it is listed in Aetna's clinical policy bulletin for back braces. Document Cobb angle, progression, and the underlying neuromuscular condition to support authorization.

05Which MS-DRGs does M41.47 map to for surgical cases?

When paired with a spinal fusion procedure, M41.47 groups to MS-DRGs 456, 457, or 458 (spinal fusion except cervical with spinal curvature, stratified by MCC/CC). For medical management without surgery, it maps to MS-DRGs 551 or 552 (medical back problems with or without MCC).

06Can M41.47 be used for pediatric patients?

Yes. Neuromuscular scoliosis in the lumbosacral region codes to M41.47 regardless of patient age. There is no age restriction in the M41.4x subcategory, unlike adolescent idiopathic scoliosis codes (M41.1x), which apply to ages 10–17.

07What imaging documentation is required to support M41.47?

A standing full-length PA spine radiograph with a documented Cobb angle measurement, the apex vertebra identified, and the curve's regional extent noted (lumbosacral) is standard. Kellgren-Lawrence grading is not applicable here — document curve magnitude and progression instead.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

01CDC ICD-10-CM Tabular List 2026 (FY2026, effective Oct 1, 2025)
02
icd10data.com
https://www.icd10data.com/ICD10CM/Codes/M00-M99/M40-M43/M41-/M41.47
03
aapc.com
https://www.aapc.com/codes/icd-10-codes/M41.47
04
cms.gov
https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=53057&ver=63
05
cms.gov
https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53064&ver=81
06
clear-institute.org
https://clear-institute.org/blog/icd-10-coding-for-scoliosis/
07
aetna.com
https://www.aetna.com/cpb/medical/data/1_99/0009.html

Mira AI Scribe

Mira AI Scribe captures the named neuromuscular diagnosis, Cobb angle with apex vertebra, curve location confirmed on imaging, and any prior treatment history (bracing, fusion levels). That documentation prevents downcoding to the unspecified site (M41.40), avoids a claim for secondary scoliosis (M41.57), and satisfies CMS medical necessity requirements for orthotics and therapy referrals tied to M41.47.

See how Mira captures M41.47 documentation