ICD-10-CM · Spine

M43.02

Acquired defect or stress fracture of the pars interarticularis in one or more cervical vertebrae, classified as a deforming dorsopathy of the cervical spine region.

Verified May 8, 2026 · 5 sources ↓

Status
Billable
Chapter
13
Related CPT
13
Region
Spine
Drawn from CDCICD10DataAAPCCdekCMS

Documentation tips

What should appear in the chart to support M43.02.

Source · Editorial brief grounded in 5 cited references ↓

  • Specify 'cervical' as the spinal region affected — M43.02 requires region-level specificity; a note that says only 'spondylolysis' will drop to the non-billable parent M43.0.
  • Document that the defect is acquired, not congenital — congenital spondylolysis routes to Q76.2 and is an Excludes1 exclusion at the M43.0 level.
  • Record the imaging modality and findings that confirm the pars defect: CT is preferred; document Hounsfield density, fracture line location, or sclerosis at the pars interarticularis if available.
  • If a vertebral slip is also present, document whether the clinical diagnosis is spondylolysis (pars defect only) or spondylolisthesis (slip confirmed), because they cannot be coded together under the Excludes1 rule.
  • Capture any neurological findings (radiculopathy, myelopathy, sensory or motor deficits) as separate secondary diagnoses to reflect full clinical complexity and support DRG MCC/CC capture.
  • Document history of conservative care (collar immobilization, physical therapy, NSAIDs) when surgical or interventional management is planned — this establishes medical necessity.

Related CPT procedures

Procedure codes commonly billed with M43.02. Linking the right diagnosis to the right procedure is what establishes medical necessity.

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

72040 $39.75
Radiologic examination of the cervical spine capturing two or three views (e.g., AP, lateral, oblique).
72050 $55.11
Radiologic examination of the cervical spine capturing a minimum of four views, used to evaluate alignment, fractures, degeneration, or other structural pathology of the neck.
72052 $62.79
Radiologic examination of the cervical spine using six or more distinct views, the highest-level plain-film cervical series in the CPT spine imaging family.
72141 $190.72
MRI of the cervical spinal canal and its contents performed without contrast material.
63001 $1,193.75
Posterior cervical laminectomy covering 1 or 2 vertebral segments, performed to decompress the spinal cord or cauda equina, without facetectomy, foraminotomy, or discectomy.
63045 $1,249.53
Open cervical laminectomy with facetectomy and foraminotomy at a single vertebral level to decompress nerve roots or the spinal cord.
22548 $1,943.60
Arthrodesis of the clivus-C1-C2 complex via anterior transoral or extraoral approach, with or without odontoid process excision.
22600 $1,282.93
Posterior or posterolateral cervical spinal fusion at a single interspace below C2, performed through a posterior approach to achieve bony arthrodesis.
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.
97110 $29.06
Therapeutic exercise billed per 15-minute unit, targeting strength, endurance, range of motion, or flexibility with direct one-on-one patient contact.
72156 View procedure details
72321 View procedure details
97012 View procedure details

Common coding pitfalls

The recurring mistakes coders make with M43.02 and adjacent codes.

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

  • Assigning M43.02 alongside M43.12 (cervical spondylolisthesis) violates the Excludes1 note at M43.0 — if the vertebra has slipped, use M43.12 only.
  • Using M43.02 for congenital cervical pars defects — congenital spondylolysis is Q76.2; M43.02 is reserved for acquired defects.
  • Defaulting to lumbar spondylolysis codes (M43.06) when the operative or radiology report documents a cervical-level finding — always verify the spinal level against imaging.
  • Leaving the diagnosis at the non-billable parent M43.0 when the region is clearly documented as cervical — M43.02 is the billable, region-specific code and must be used.
  • Failing to code associated radiculopathy or myelopathy separately, which understates clinical complexity and can suppress MCC/CC DRG assignment.

Clinical context

Source · Editorial summary grounded in 5 cited references ↓

M43.02 captures acquired spondylolysis confined to the cervical region (C1–C7). The lesion represents a defect in the pars interarticularis — the bony bridge connecting the superior and inferior articular processes of a cervical vertebra. It is distinct from the far more common lumbar spondylolysis and must be supported by imaging (CT is the gold standard; plain radiographs and MRI may also identify the defect or associated edema). Use this code only when the defect is documented as acquired; congenital spondylolysis maps to Q76.2, not M43.02.

The critical Excludes1 note at M43.0 bars simultaneous use of M43.02 with spondylolisthesis codes (M43.1x). If imaging confirms the vertebra has already slipped forward, the diagnosis is cervical spondylolisthesis (M43.12), not spondylolysis. Spondylolysis is the pars defect alone; spondylolisthesis is the resultant displacement. When both pathologies are mentioned in the record, query the provider for the primary diagnosis before assigning codes.

MS-DRG grouping places M43.02 in DRG 551 (Medical back problems with MCC) or 552 (without MCC), so documented comorbidities and complications directly affect reimbursement weight. Code any associated cervical radiculopathy, myelopathy, or instability as secondary diagnoses to fully reflect complexity and support medical necessity for advanced imaging, bracing, or surgical intervention.

Sibling codes

Other billable codes under M43.0 (laterality / anatomic variants).

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What is the difference between M43.02 and M43.12?
M43.02 is spondylolysis — a pars interarticularis defect in the cervical spine with no confirmed vertebral slip. M43.12 is cervical spondylolisthesis — the vertebra has displaced forward. These two codes cannot be used together (Excludes1). If slippage is confirmed on imaging, assign M43.12.
02Can I use M43.02 for a congenital cervical pars defect?
No. Congenital spondylolysis is excluded from M43.0 by an Excludes1 note and maps to Q76.2. M43.02 is used only for acquired defects. Verify with the provider whether the condition is developmental or acquired.
03Which imaging supports M43.02, and should I document the modality?
CT scanning is the gold standard for identifying pars interarticularis defects and should be cited in documentation. Plain radiographs (oblique views) and MRI (bone marrow edema at the pars) also support the diagnosis. Documenting the modality and specific findings strengthens medical necessity for the code.
04Does M43.02 require a 7th character?
No. M43.02 is a complete billable code with no 7th character extension. The 7th character injury extensions (A, D, S) apply to S-codes (trauma/injury chapter), not to M-codes like M43.02.
05How does M43.02 affect DRG assignment?
M43.02 groups to MS-DRG 551 (Medical back problems with MCC) or 552 (without MCC) under DRG v43.0. Documenting and coding comorbidities that qualify as MCCs or CCs will shift the case to the higher-weighted DRG 551, directly impacting reimbursement.
06Should I code cervical radiculopathy separately when it accompanies M43.02?
Yes. Cervical radiculopathy (M54.12) or myelopathy should be coded as a secondary diagnosis when documented. These are not bundled into M43.02 and their presence can contribute to MCC/CC capture, supporting a higher DRG weight.
07What approximate synonyms are accepted for M43.02 in the ICD-10-CM index?
Accepted index entries include 'acquired cervical spondylolysis,' 'acquired cervical (neck) spondylolysis,' and 'spondylolysis of cervical spine.' All route to M43.02 in the FY2026 tabular list.

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
    icd10data.com
    https://www.icd10data.com/ICD10CM/Codes/M00-M99/M40-M43/M43-/M43.02
  3. 03
    aapc.com
    https://www.aapc.com/codes/icd-10-codes/M43.02
  4. 04
    cdek.pharmacy.purdue.edu
    https://cdek.pharmacy.purdue.edu/icd10/M43.0/
  5. 05CMS MS-DRG v43.0 Grouper — DRG 551/552

Mira AI Scribe

Mira AI Scribe captures the documented spinal level (cervical), confirmation that the defect is acquired rather than congenital, imaging modality and findings (CT/MRI pars defect, fracture line, sclerosis), presence or absence of vertebral slip, and any neurological symptoms (radiculopathy, myelopathy). Complete capture prevents downcoding to the non-billable M43.0, blocks an erroneous Q76.2 congenital assignment, and ensures associated neurological diagnoses are coded to support DRG MCC/CC grouping.

See how Mira captures M43.02 documentation

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