ICD-10-CM · Spine

M42.14

M42.14 identifies adult osteochondrosis of the spine localized to the thoracic region — degenerative changes in the vertebral body endplates and intervertebral discs, including conditions such as Scheuermann-type deformity in adults and Kümmell disease.

Verified May 8, 2026 · 4 sources ↓

Status
Billable
Chapter
13
Related CPT
13
Region
Spine
Drawn from CDCAAPCICD10Data

Documentation tips

What should appear in the chart to support M42.14.

Source · Editorial brief grounded in 4 cited references ↓

  • Specify 'thoracic spine' or individual vertebral levels (e.g., T6–T10) in the clinical note — 'spinal osteochondrosis' without region defaults to unspecified M42.9.
  • Record imaging findings that confirm thoracic involvement: vertebral endplate irregularity, anterior wedging, Schmorl nodes, or disc height reduction on plain film or MRI.
  • Distinguish adult from juvenile presentation — document patient age or note skeletal maturity to justify M42.14 over M42.04 (juvenile, thoracic).
  • Document symptom duration and any prior conservative measures (physical therapy, NSAIDs, injections) to support medical necessity for advanced imaging or procedural intervention.
  • If thoracic kyphosis is a concurrent finding, code it separately (e.g., M40.04) unless the kyphosis is solely the structural consequence documented as part of the osteochondrosis.

Related CPT procedures

Procedure codes commonly billed with M42.14. 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 M42.14 and adjacent codes.

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

  • Assigning M42.9 (unspecified) when the operative report or imaging clearly documents thoracic-level disease — this downcodes specificity and can trigger payer queries.
  • Using M42.14 for juvenile patients or adolescents with Scheuermann disease — those cases belong under M42.0x (juvenile osteochondrosis), not M42.1x.
  • Confusing thoracic osteochondrosis with thoracic disc degeneration (M51.14) — osteochondrosis primarily involves the vertebral body and endplates; disc degeneration codes apply when the disc itself is the documented pathology.
  • Failing to add a separate code for thoracic kyphosis when it is documented as a distinct clinical finding, not merely incidental to the osteochondrosis.
  • Selecting M42.14 for thoracolumbar pathology when documentation supports involvement of both thoracic and lumbar regions — consider whether M42.16 (lumbar) should be added.

Clinical context

Source · Editorial summary grounded in 4 cited references ↓

M42.14 applies when a skeletally mature patient presents with osteochondrosis affecting the thoracic vertebrae. The condition involves endplate irregularity, disc height loss, and anterior vertebral wedging at the thoracic level, often associated with thoracic kyphosis and mid-back pain. It belongs to the M42.1 adult osteochondrosis branch, which distinguishes it from juvenile spinal osteochondrosis (M42.0) — the adult designation requires clinical or radiographic evidence that skeletal maturity is established.

The thoracic region specificity of M42.14 is required when documentation and imaging localize the osteochondrosis to T1–T12. If the pathology spans the thoracolumbar junction or multiple spinal regions, review whether M42.14 can stand alone or whether an additional code reflecting the lumbar segment (M42.16) is warranted. Do not default to M42.9 (spinal osteochondrosis, unspecified) when thoracic involvement is clearly documented.

This code is commonly paired with procedure codes for thoracic imaging, physical therapy evaluation, and spinal injections when conservative management is the treatment path. In surgical cases — such as kyphosis correction or posterior spinal fusion — M42.14 serves as the primary or supporting diagnosis justifying the procedure.

Sibling codes

Other billable codes under M42.1 (laterality / anatomic variants).

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 4 cited references ↓

01What is the difference between M42.14 and M51.14?
M42.14 targets osteochondrosis — primarily vertebral body endplate and structural changes. M51.14 codes thoracic intervertebral disc degeneration when the disc itself is the documented pathology. Use the code that matches what the clinician's note and imaging describe.
02Can M42.14 be used for Scheuermann disease in an adult?
Yes. When a patient has Scheuermann-type kyphosis but is skeletally mature, M42.14 is appropriate. Juvenile-onset cases in skeletally immature patients use M42.04.
03Should I also code thoracic kyphosis separately when it coexists with M42.14?
Code thoracic kyphosis separately (e.g., M40.04) if the clinician documents it as a distinct condition with its own clinical significance. If the kyphosis is listed solely as a structural result of the osteochondrosis and nothing more, separate coding may not add specificity — follow documentation.
04Is M42.14 billable as a primary diagnosis for thoracic MRI?
Yes, M42.14 is a fully billable code and can support medical necessity for thoracic spine MRI (CPT 72148 or 72156). Ensure documentation reflects the clinical indication — pain, neurologic signs, or monitoring of known disease.
05When does M42.14 apply versus M42.9?
Use M42.14 any time thoracic-region involvement is specified in documentation or imaging. Reserve M42.9 only when the medical record genuinely does not identify which spinal region is affected — which is rare once imaging is available.
06Does M42.14 require a seventh character?
No. M42.14 is a standard M-code in Chapter 13 (musculoskeletal). Seventh-character extensions (A/D/S) apply to injury S-codes, not to M-codes. M42.14 is complete as a six-character code.
07What CPT codes are commonly linked to M42.14 encounters?
Thoracic spine X-ray series (72070–72074), thoracic MRI without/with contrast (72148, 72156), bone density scan (77080), thoracic epidural steroid injection (62321), spinal fusion procedures (22532, 22533, 22800), and therapeutic exercise (97110) are frequently paired with this diagnosis.

Sources & references

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

  1. 01CDC ICD-10-CM Tabular List 2026 (FY2026, effective Oct 1, 2025)
  2. 02
    aapc.com
    https://www.aapc.com/codes/icd-10-codes/M42.14
  3. 03
    icd10data.com
    https://www.icd10data.com/ICD10CM/Codes/M00-M99/M40-M43/M42-/M42.14
  4. 04
    aapc.com
    https://www.aapc.com/codes/icd-10-codes/M42

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Mira's AI scribe captures thoracic vertebral level, imaging findings (endplate irregularity, wedging, Schmorl nodes, Kümmell changes), patient age confirming skeletal maturity, and any documented kyphosis or functional limitation — preventing a drop to unspecified M42.9 and ensuring the record supports medical necessity for imaging, injections, or surgical planning.

See how Mira captures M42.14 documentation

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