ICD-10-CM · Spine

M46.02

Disorder of ligamentous or muscular attachments (entheses) at the cervical spine, classified under other inflammatory spondylopathies.

Verified May 8, 2026 · 5 sources ↓

Status: Billable
Chapter: 13
Related CPT: 10
Region: Spine

Drawn from CDCicd10data.com —AAPCCMS

Documentation tips

What should appear in the chart to support M46.02.

Source · Editorial brief grounded in 5 cited references ↓

Document the specific region as 'cervical' — terms like 'neck spine' or 'cervical spine' map directly to M46.02 in the ICD-10-CM index.
Note the nature of the pathology: specify whether it involves ligamentous, tendinous, or muscular attachment sites at the cervical vertebrae.
Record imaging findings that support an inflammatory process (e.g., bone marrow edema on MRI, erosions at entheses) to distinguish from degenerative spondylosis.
If the pathology extends into the upper thoracic levels, document the full span so the coder can assess whether M46.03 (cervicothoracic) is more precise.
Record any associated diagnoses such as spondyloarthropathy or psoriatic arthritis that may need to be coded as a primary or additional diagnosis.

Related CPT procedures

Procedure codes commonly billed with M46.02. 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.

99213 $95.19

Established patient office or outpatient visit requiring 20–29 minutes of total time or low-complexity medical decision-making.

99214 $135.61

Office visit for an established patient requiring moderate-complexity medical decision making (MDM), or 30–39 minutes of total provider time on the date of service.

20610 $68.81

Aspiration and/or injection of a major joint or bursa (shoulder, hip, knee, or subacromial bursa) performed without ultrasound guidance.

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

97530 View procedure details

Common coding pitfalls

The recurring mistakes coders make with M46.02 and adjacent codes.

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

Using M46.02 for degenerative cervical disease: if imaging shows osteophytes or disc space narrowing without inflammatory features, M47.812 or M47.22 is correct, not M46.02.
Defaulting to M46.00 (site unspecified) when the cervical region is clearly documented — always code to the highest specificity available.
Confusing M46.02 (cervical) with M46.03 (cervicothoracic): if the enthesopathy spans both levels, use the code matching the primary or documented region of involvement.
Omitting a primary spondyloarthropathy code (e.g., ankylosing spondylitis M45.x, psoriatic arthritis L40.5x) when spinal enthesopathy is a manifestation of an underlying systemic condition — sequence the primary condition first.

Clinical context

Source · Editorial summary grounded in 5 cited references ↓

M46.02 applies when the clinical picture involves pathological changes at the insertion points of tendons, ligaments, or muscles along the cervical vertebrae (C1–C7 region). The parent category M46.0 covers spinal enthesopathy broadly; M46.02 pins the pathology to the cervical region specifically. If the enthesopathy spans the cervical and upper thoracic levels, step down to M46.03 (cervicothoracic region) instead.

This code sits within the 'Other Inflammatory Spondylopathies' block (M46), which distinguishes it from degenerative cervical pathology coded under M47.x (spondylosis). Per AAPC forum guidance, imaging should reflect an inflammatory process to justify M46.xx; if imaging shows degenerative change without inflammatory features, cervical spondylosis codes (M47.812, M47.22, etc.) are more appropriate. Coders should look for clinical language such as 'cervical enthesopathy,' 'attachment site inflammation at cervical spine,' or 'ligamentous/tendinous insertion disorder, cervical.'

M46.02 maps to MS-DRG 551 (Medical back problems with MCC) or 552 (Medical back problems without MCC) under MS-DRG v43.0. No 7th-character extension is required — M-codes do not use the A/D/S convention.

Sibling codes

Other billable codes under M46.0 (laterality / anatomic variants).

M46.00

Spinal enthesopathy, site unspecified

M46.04

Spinal enthesopathy, thoracic region

M46.06

Spinal enthesopathy, lumbar region

M46.01

Spinal enthesopathy, occipito-atlanto-axial region

M46.05

Spinal enthesopathy, thoracolumbar region

M46.09

Spinal enthesopathy, multiple sites in spine

M46.07

Spinal enthesopathy, lumbosacral region

M46.03

Spinal enthesopathy, cervicothoracic region

Frequently asked questions

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

01What distinguishes M46.02 from M47.812 (spondylosis, cervical region)?

M46.02 represents an inflammatory enthesopathy at cervical attachment sites; M47.812 reflects degenerative spondylosis. Use M46.02 when imaging or clinical findings indicate an inflammatory process. If the process is primarily degenerative (joint space narrowing, osteophytes, disc degeneration), code to M47.8x or M47.2x.

02Can M46.02 be used alongside an ankylosing spondylitis code?

Yes. If cervical enthesopathy is a manifestation of ankylosing spondylitis, code the underlying condition (M45.x) as the primary diagnosis and M46.02 as an additional code if it adds clinical specificity. Follow sequencing rules for the encounter type.

03Does M46.02 require a 7th-character extension?

No. M46.02 is an M-code and does not use the 7th-character A/D/S extension. That convention applies to injury codes (S-codes).

04What if the enthesopathy involves both the cervical and thoracic regions?

Use M46.03 for cervicothoracic region involvement, or report both M46.02 and M46.04 if the cervical and thoracic segments are distinctly documented. Let the physician's documentation of the primary region guide sequencing.

05What imaging documentation best supports M46.02?

MRI findings of bone marrow edema, entheseal erosions, or soft-tissue inflammation at cervical vertebral attachment sites support an inflammatory coding rationale. Plain film osteophytes or disc space narrowing alone lean toward degenerative codes. Documenting the Kellgren-Lawrence equivalent or a radiologist's use of 'inflammatory' language strengthens the audit trail.

06Which MS-DRGs does M46.02 map to?

M46.02 groups to MS-DRG 551 (Medical back problems with MCC) or 552 (Medical back problems without MCC) under MS-DRG v43.0, depending on the presence of a major complication or comorbidity.

07Is M46.02 appropriate for a patient with diffuse idiopathic skeletal hyperostosis (DISH) at the cervical spine?

DISH is classified under M48.1x (Diffuse idiopathic skeletal hyperostosis), not M46.02. M46.02 is reserved for enthesopathy with an inflammatory rather than ossifying/hyperostotic mechanism. Query the provider if documentation is ambiguous between the two.

Sources & references

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

01CDC ICD-10-CM Tabular List 2026 — https://www.cdc.gov/nchs/icd/icd-10-cm/index.html
02icd10data.com — https://www.icd10data.com/ICD10CM/Codes/M00-M99/M45-M49/M46-/M46.02
03AAPC Codify — https://www.aapc.com/codes/icd-10-codes/M46.02
04CMS MS-DRG v43.0 Grouper Logic
05CMS ICD-10-CM Official Guidelines for Coding and Reporting — https://www.cms.gov/Medicare/Coding/ICD10

Mira AI Scribe

Mira AI Scribe captures the documented spinal region (cervical), the nature of the entheseal pathology (ligamentous, tendinous, or muscular insertion), imaging characterization (inflammatory vs. degenerative findings), and any underlying spondyloarthropathy. Precise capture of these elements prevents fallback to the unspecified M46.00 and avoids miscoding to degenerative spondylosis categories — both of which can trigger payer audits or downcoding.

See how Mira captures M46.02 documentation