ICD-10-CM · Spine

M43.19

Forward displacement of one vertebral body over the one below it, occurring at two or more distinct spinal levels simultaneously.

Verified May 8, 2026 · 4 sources ↓

Status: Billable
Chapter: 13
Related CPT: 19
Region: Spine

Drawn from CDCICD10DataAAPC

Documentation tips

What should appear in the chart to support M43.19.

Source · Editorial brief grounded in 4 cited references ↓

Name every affected level explicitly in the note (e.g., 'Grade II spondylolisthesis at L4-L5 and Grade I at L5-S1') — 'multilevel' alone is insufficient for audit defense.
Record the Meyerding grade at each level; grade progression across levels affects surgical planning and supports medical necessity.
Specify acquisition type (degenerative, isthmic, traumatic, iatrogenic) to distinguish M43.19 from congenital spondylolisthesis (Q76.2).
Document imaging modality and date — MRI or standing lateral radiograph findings (percent slip, angular kyphosis, disc height) anchor the diagnosis.
If neurological symptoms accompany the slip, add codes for radiculopathy or stenosis at the appropriate levels; M43.19 does not capture neural compromise.

Related CPT procedures

Procedure codes commonly billed with M43.19. 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.

22614 $349.37

Add-on code for each additional interspace treated by posterior or posterolateral arthrodesis beyond the first level billed with a primary fusion code.

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.

22632 $287.58

Add-on code for posterior interbody lumbar arthrodesis at each additional interspace beyond the first, including any laminectomy or discectomy needed to prepare the interspace.

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.

22634 $432.54

Add-on code for each additional interspace and segment of combined posterior/posterolateral and posterior interbody lumbar arthrodesis, including laminectomy and/or discectomy sufficient to prepare the disc space.

22800 $1,312.99

Posterior spinal arthrodesis for deformity correction spanning up to 6 vertebral segments, 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.

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.

22854 $300.61

Insertion of an intervertebral biomechanical device — such as a synthetic cage or mesh — into a disc space, including integral anterior instrumentation used to anchor the device, performed in conjunction with interbody arthrodesis at each interspace.

63012 $1,149.66

Lumbar laminectomy with removal of abnormal facets and/or pars interarticularis, with decompression of the cauda equina and nerve roots for spondylolisthesis (Gill-type procedure).

63030 $898.15

Single-interspace lumbar laminotomy with nerve root decompression, including partial facetectomy, foraminotomy, and/or herniated disc excision performed via open surgical technique.

63047 $1,065.49

Lumbar laminectomy at a single vertebral segment that also includes facetectomy and foraminotomy for decompression of the spinal cord, cauda equina, and/or nerve roots — unilateral or bilateral.

63048 $187.38

Add-on code for laminectomy, facetectomy, and foraminotomy at each additional cervical, thoracic, or lumbar vertebral segment beyond the primary segment.

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.

72158 $318.31

MRI of the lumbar spinal canal and its contents performed first without contrast, then repeated after contrast administration for enhanced visualization.

Common coding pitfalls

The recurring mistakes coders make with M43.19 and adjacent codes.

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

Using M43.19 when only one level is affected — if imaging shows a single-level slip, use the site-specific M43.10–M43.18 code.
Confusing acquired multilevel spondylolisthesis (M43.19) with congenital spondylolisthesis (Q76.2) — the etiology must be documented as acquired for M43.19 to be valid.
Omitting companion codes for spinal stenosis or radiculopathy at each involved level, which leaves clinical complexity — and reimbursement — on the table.
Coding M43.19 from a radiologist's preliminary read without provider confirmation of acquired, multilevel involvement in the clinical note.

Clinical context

Source · Editorial summary grounded in 4 cited references ↓

M43.19 applies when spondylolisthesis — anterior slippage of a superior vertebra over the vertebra below — is documented at multiple spinal sites. This is the correct code when imaging or operative findings confirm involvement at more than one level (e.g., L4-L5 and L5-S1, or a cervical level combined with a lumbar level). If only a single level is involved, use the site-specific code from M43.10–M43.18 instead.

This code covers acquired spondylolisthesis at multiple sites. Congenital spondylolisthesis is excluded here and belongs under Q76.2. If the slip is isthmic (spondylolysis-related), ensure the clinical documentation supports an acquired etiology; otherwise, clarify with the treating provider. Degenerative, traumatic, and iatrogenic multilevel slips all route to M43.19 when no single-level code captures the full picture.

M43.19 groups into MS-DRG 551 (Medical back problems with MCC) or 552 (without MCC). When multilevel spondylolisthesis drives a surgical decision, sequence M43.19 as the principal diagnosis and add procedure codes reflecting all levels addressed. Additional codes for associated radiculopathy, spinal stenosis, or neurogenic claudication should be reported separately to fully represent the clinical burden.

Sibling codes

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

M43.14

Spondylolisthesis, thoracic region

M43.12

Spondylolisthesis, cervical region

M43.17

Spondylolisthesis, lumbosacral region

M43.15

Spondylolisthesis, thoracolumbar region

M43.16

Spondylolisthesis, lumbar region

M43.18

Spondylolisthesis, sacral and sacrococcygeal region

M43.10

Spondylolisthesis, site unspecified

M43.11

Spondylolisthesis, occipito-atlanto-axial region

Frequently asked questions

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

01When does multilevel spondylolisthesis qualify for M43.19 vs. separate single-level codes?

Use M43.19 when the provider documents spondylolisthesis at two or more discrete spinal levels. ICD-10-CM does not instruct you to stack single-level M43.1x codes for multilevel disease — M43.19 is the correct single code for that scenario.

02Can M43.19 be used for congenital multilevel spondylolisthesis?

No. Congenital spondylolisthesis maps to Q76.2 regardless of how many levels are involved. M43.19 is for acquired multilevel slippage. If the note is ambiguous, query the treating provider before coding.

03Should I code associated spinal stenosis separately when using M43.19?

Yes. M43.19 captures the structural slip only. Spinal stenosis (M48.0x), lumbar radiculopathy (M54.4x), or neurogenic claudication should be coded in addition to fully represent the clinical picture and support medical necessity.

04What MS-DRG does M43.19 typically group to?

M43.19 groups to MS-DRG 551 (Medical back problems with MCC) or 552 (Medical back problems without MCC) per MS-DRG v43.0, depending on the presence of a major complication or comorbidity.

05Is M43.19 valid for surgical encounters, or only medical management?

M43.19 is valid for any encounter type — office visit, surgical, or hospital. For surgery, sequence it as the principal diagnosis when the multilevel slip is the condition that drove the operative decision, and report all procedure codes reflecting the levels treated.

06How does M43.19 differ from M43.18 (spondylolisthesis, sacral and sacrococcygeal region)?

M43.18 is site-specific to the sacral/sacrococcygeal region — one level, one region. M43.19 requires documentation of involvement at more than one spinal site. If the slip is limited to the sacral region, use M43.18.

Sources & references

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

01CDC ICD-10-CM Tabular List 2026 (effective Oct 1, 2025)
02
icd10data.com
https://www.icd10data.com/ICD10CM/Codes/M00-M99/M40-M43/M43-/M43.19
03
aapc.com
https://www.aapc.com/codes/icd-10-codes/M43.19
04
aapc.com
https://www.aapc.com/codes/icd-10-codes/M43.1

Mira AI Scribe

Mira captures the number of affected levels, Meyerding grade at each level, imaging modality and date, acquisition type (degenerative/isthmic/traumatic), and any associated neurological symptoms — preventing a downcode to the unspecified M43.10 or a missing companion code for stenosis or radiculopathy that would leave clinical severity undocumented at audit.

See how Mira captures M43.19 documentation