ICD-10-CM · Spine

M43.17

Anterior vertebral slippage at the lumbosacral junction, specifically the L5-S1 level, classified as an acquired or degenerative condition rather than a traumatic fracture or congenital defect.

Verified May 8, 2026 · 6 sources ↓

Status
Billable
Chapter
13
Related CPT
10
Region
Spine
Drawn from CDCICD10DataAAPCIcdcodesOutsourcestrategies

Documentation tips

What should appear in the chart to support M43.17.

Source · Editorial brief grounded in 6 cited references ↓

  • Specify the vertebral level explicitly — 'L5-S1 spondylolisthesis' — not just 'lumbosacral' or 'lower back slip', to support M43.17 over M43.16 or M43.10.
  • Record the Meyerding grade (I–IV) or percentage of anterior translation on standing lateral radiograph; this supports medical necessity for surgical referral or fusion.
  • Note whether the spondylolisthesis is isthmic (pars defect), degenerative, or dysplastic, as etiology affects surgical planning and payer authorization even though the ICD-10 code is the same.
  • Document whether flexion-extension films show dynamic instability, which differentiates stable from unstable slippage and drives step-therapy requirements for many payers.
  • If the patient has a prior fusion at L5-S1, note that separately; adjacent-level disease changes the surgical CPT code selection and may require an additional diagnosis code.
  • Confirm the condition is not acute traumatic or congenital before assigning M43.17 — Excludes1 conditions are coding errors, not just documentation gaps.

Related CPT procedures

Procedure codes commonly billed with M43.17. Linking the right diagnosis to the right procedure is what establishes medical necessity.

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

22612 $1,467.64
Posterior or posterolateral lumbar arthrodesis of a single interspace, performed via a posterior approach with bone graft and typically pedicle screw fixation to achieve vertebral segment fusion.
22630 $1,510.72
Posterior interbody arthrodesis of a single lumbar interspace, including laminectomy and/or discectomy performed to prepare the interspace for fusion rather than for decompression.
22633 $1,700.11
Single-level lumbar arthrodesis combining posterior or posterolateral technique with posterior interbody technique, including laminectomy and/or discectomy sufficient to prepare the interspace — performed as one surgical session at one lumbar interspace.
22558 $1,423.88
Anterior interbody arthrodesis of the lumbar spine using an anterior or anterolateral approach, including the minimal discectomy required to prepare the interspace for fusion.
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.
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.
72148 $191.72
Non-contrast MRI of the lumbar spine used to evaluate disc pathology, spinal stenosis, nerve root compression, and other structural abnormalities without administration of contrast material.
27279 $758.53
Minimally invasive arthrodesis of the sacroiliac joint using a transfixing implant device placed percutaneously across the joint.
64483 View procedure details

Common coding pitfalls

The recurring mistakes coders make with M43.17 and adjacent codes.

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

  • Assigning M43.17 when the imaging report says 'lumbar spondylolisthesis at L4-L5' — that is M43.16, not M43.17; the lumbosacral code is L5-S1 only.
  • Using M43.17 for acute traumatic lumbosacral slippage — that is an Excludes1 violation; code to S33.1xx with the appropriate 7th character (A, D, or S) instead.
  • Defaulting to M43.10 (site unspecified) when the physician note references 'lumbosacral' but query would confirm L5-S1 — specificity is billable and should not be abandoned without querying.
  • Confusing spondylolisthesis (M43.17) with spondylolysis (M43.07); spondylolysis is a pars defect without forward slip — if both are documented, both codes may be reported.
  • Omitting M43.17 entirely when a spinal fusion is coded, assuming the diagnosis is captured in the procedure — payers require the ICD-10 diagnosis code on the claim regardless of procedure specificity.

Clinical context

Source · Editorial summary grounded in 6 cited references ↓

M43.17 applies exclusively to spondylolisthesis at the lumbosacral region — the L5-S1 junction. If the slip is documented at L4-L5, use M43.16 (lumbar region). If the note reads 'lumbar spondylolisthesis' without specifying the level, query the provider before defaulting to unspecified M43.10; L5-S1 is the most common site but specificity must come from the provider, not the coder.

Three Excludes1 conditions must be ruled out before using M43.17. Acute traumatic spondylolisthesis of the lumbosacral region codes to S33.1 (fracture category). Acute traumatic slippage at other spinal sites codes to the appropriate fracture code for that region. Congenital spondylolisthesis codes to Q76.2. M43.17 is reserved for acquired, degenerative, or isthmic (lytic) presentations that are not acute traumatic and not congenital.

Common clinical scenarios that generate M43.17 include isthmic spondylolisthesis from a pars interarticularis defect at L5, degenerative spondylolisthesis at L5-S1, and pre- or post-operative documentation of L5-S1 slippage in fusion workups. The Meyerding grade (I through IV) and percentage slip documented on standing lateral radiographs or flexion-extension films support medical necessity for conservative care, injections, or surgical intervention.

Sibling codes

Other billable codes under M43.1 (laterality / anatomic variants).

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What is the difference between M43.16 and M43.17?
M43.16 is spondylolisthesis of the lumbar region (L4-L5); M43.17 is spondylolisthesis of the lumbosacral region (L5-S1). The two are mutually exclusive — select based on the level documented by the provider or confirmed on imaging.
02Can M43.17 be used for isthmic (pars defect) spondylolisthesis at L5-S1?
Yes. M43.17 covers acquired spondylolisthesis including isthmic and degenerative types at L5-S1. The ICD-10-CM tabular includes '(acquired) (degenerative)' in the index entry. Etiology does not change the code, but should be documented for clinical and surgical planning purposes.
03What code replaces M43.17 for an acute traumatic lumbosacral slippage?
Acute traumatic spondylolisthesis of the lumbosacral region is an Excludes1 condition — use S33.1 with the appropriate 7th character: A for initial encounter, D for subsequent, S for sequela. M43.17 cannot be reported alongside S33.1 for the same condition.
04Is M43.17 appropriate when both L4-L5 and L5-S1 slippage are documented?
No single code covers both levels. Report M43.16 (lumbar) and M43.17 (lumbosacral) together when both levels are documented. Alternatively, M43.19 (multiple sites) may apply — but if individual levels are specified in documentation, report each discrete level code.
05Which CPT codes for lumbar fusion commonly pair with M43.17?
Posterior lumbar interbody fusion at L5-S1 (CPT 22630), posterior lumbar fusion (22612), combined anterior-posterior fusion (22633), and anterior lumbar interbody fusion (22558) are the most common surgical pairings. Injection procedures such as transforaminal epidural steroid injection (64483) also pair with M43.17 for conservative management.
06Does M43.17 require a 7th character?
No. M43.17 is an M-code (musculoskeletal disease code) and does not use 7th-character extensions. The A/D/S encounter designations apply to injury S-codes only.
07Should congenital spondylolisthesis at L5-S1 be coded to M43.17?
No. Congenital spondylolisthesis is an Excludes1 condition under M43.1. Use Q76.2 for congenital spondylolisthesis. M43.17 is reserved for acquired presentations.

Mira AI Scribe

Mira captures the vertebral level (L5-S1), Meyerding grade or slip percentage from standing lateral imaging, presence or absence of pars defect, and any instability noted on flexion-extension films. That documentation locks in M43.17 over the unspecified M43.10, prevents Excludes1 conflicts with traumatic or congenital codes, and satisfies payer medical necessity criteria for fusion or injection procedures.

See how Mira captures M43.17 documentation

Related ICD-10 codes

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