Spondylolisthesis localized to the cervicothoracic junction, where one vertebra has translated anteriorly relative to the vertebra immediately below it at the C7-T1 transition zone.
Verified May 8, 2026 · 4 sources ↓
- Status
- Billable
- Chapter
- 13
- Related CPT
- 9
- Region
- Spine
Documentation tips
What should appear in the chart to support M43.13.
Source · Editorial brief grounded in 4 cited references ↓
- Specify the vertebral level(s) involved by name — C7-T1 or 'cervicothoracic junction' — so the coder can confirm M43.13 over adjacent-region codes M43.12 or M43.14.
- Record the type or grade of spondylolisthesis (e.g., degenerative, isthmic/spondylolytic, Meyerding Grade I-IV) to support medical necessity and surgical planning documentation.
- Cite the imaging modality and key finding: plain radiograph with measurable anterior slip, CT showing pars defect, or MRI with canal compromise — all strengthen the diagnosis and payer audit defense.
- Document whether the condition is symptomatic (radiculopathy, myelopathy, neck/upper back pain) to support additional diagnosis codes and justify the level of service.
- Explicitly exclude acute trauma and congenital etiology in the note; a single sentence ('no acute fracture identified; no congenital vertebral anomaly') protects against Excludes1 violations on audit.
Related CPT procedures
Procedure codes commonly billed with M43.13. 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 M43.13 and adjacent codes.
Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓
- Assigning M43.13 after acute cervicothoracic trauma violates the Excludes1 note — acute traumatic slippage at non-lumbosacral sites must be coded to the appropriate vertebral fracture code, not M43.1x.
- Defaulting to M43.10 (site unspecified) when imaging clearly identifies the cervicothoracic level is an undercoding error; specificity is available and required when documented.
- Confusing the cervicothoracic region (C7-T1) with the cervical region (M43.12) or thoracic region (M43.14) — the coder must confirm the apex level in the imaging report before selecting the 5th character.
- Using M43.13 for congenital spondylolisthesis — Q76.2 is the correct code when a congenital origin is established, per the Excludes1 instruction under M43.1.
- Omitting secondary diagnosis codes for associated neurological compromise (e.g., cervical myelopathy M47.12, radiculopathy M54.12) when documented — these support medical necessity for advanced imaging and surgical intervention.
Clinical context
Source · Editorial summary grounded in 4 cited references ↓
M43.13 captures non-traumatic, non-congenital spondylolisthesis at the cervicothoracic region — the junction between the cervical and thoracic spine, typically the C7-T1 level. Use this code when imaging (CT, MRI, or plain radiograph) confirms vertebral slippage at that specific transition zone and the clinical record excludes acute fracture-dislocation and congenital origin.
Three Excludes1 conditions bar use of M43.13: acute traumatic spondylolisthesis of the lumbosacral region (S33.1), acute traumatic spondylolisthesis of any other spinal region (code to the appropriate vertebral fracture code instead), and congenital spondylolisthesis (Q76.2). If the mechanism is acute trauma at the cervicothoracic level, assign the fracture code for that vertebral region — not M43.13.
The cervicothoracic region is one of the least common sites for spondylolisthesis relative to lumbar and lumbosacral levels. When the slip spans or is ambiguous between the lower cervical region and the cervicothoracic junction, documentation must specify the apex level so coders can choose correctly among M43.12 (cervical), M43.13 (cervicothoracic), or M43.14 (thoracic). If the operative or imaging report identifies C7-T1 as the level, M43.13 is the correct code.
Sibling codes
Other billable codes under M43.1 (laterality / anatomic variants).
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 4 cited references ↓
01What spinal level does the cervicothoracic region refer to in ICD-10-CM?
02Can I use M43.13 after an acute traumatic injury to the cervicothoracic spine?
03Is M43.13 appropriate for congenital spondylolisthesis at the cervicothoracic level?
04Which adjacent codes should I compare before finalizing M43.13?
05Should I code associated myelopathy or radiculopathy separately from M43.13?
06Does M43.13 require a 7th character extension?
07What happens if documentation says 'lower cervical spondylolisthesis' without specifying the exact level?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01CDC ICD-10-CM Tabular List 2026 — M43.13
- 02aapc.comhttps://www.aapc.com/codes/icd-10-codes/M43.13
- 03icd10data.comhttps://www.icd10data.com/ICD10CM/Codes/M00-M99/M40-M43/M43-/M43.13
- 04outsourcestrategies.comhttps://www.outsourcestrategies.com/blog/how-to-document-spondylolisthesis-with-accurate-icd-10-codes/
Mira Scribe
Mira AI Scribe captures the imaging-confirmed vertebral level (C7-T1), slip grade, symptom duration, and any documented neurological findings (myelopathy, radiculopathy) from the encounter note. This prevents a fallback to unspecified M43.10, closes the gap on missing Excludes1 exclusion language, and ensures co-diagnoses like cervical myelopathy or radiculopathy are surfaced at coding time.
See how Mira captures M43.13 documentation