ICD-10-CM · Spine

M46.07

M46.07 identifies pathological changes at the ligamentous or muscular attachment points along the lumbosacral spine — the transitional zone where the lumbar vertebrae meet the sacrum.

Verified May 8, 2026 · 4 sources ↓

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

Drawn from CDCICD10DataAAPCCMS

Documentation tips

What should appear in the chart to support M46.07.

Source · Editorial brief grounded in 4 cited references ↓

Explicitly name the lumbosacral region (or lumbosacral junction) — 'low back' alone does not support M46.07 over an unspecified lumbar code.
Record the specific anatomical attachments involved (interspinous ligaments, iliolumbar ligament, thoracolumbar fascia insertions) when identifiable on imaging or physical exam.
Document imaging findings that support enthesopathy: MRI bone marrow edema at ligament insertion sites, CT erosions or enthesophyte formation at the lumbosacral junction.
If an underlying spondyloarthropathy (e.g., ankylosing spondylitis, psoriatic arthritis) is present, document it separately — M46.07 does not capture the systemic diagnosis.
Note conservative care history (NSAIDs, physical therapy, injections) to support medical necessity for advanced imaging or interventional procedures.

Related CPT procedures

Procedure codes commonly billed with M46.07. Linking the right diagnosis to the right procedure is what establishes medical necessity.

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

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.

72114 $61.79

Radiologic examination of the lumbosacral spine, complete series with bending (flexion/extension) views — minimum of 6 views total.

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.

27096 $175.69

Injection into the sacroiliac joint with fluoroscopic or CT image guidance, including arthrography when performed.

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.

64483 View procedure details

64484 View procedure details

97530 View procedure details

Common coding pitfalls

The recurring mistakes coders make with M46.07 and adjacent codes.

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

Assigning M46.07 when the documented site is purely lumbar (L1–L5) — that maps to M46.06, not M46.07.
Conflating lumbosacral enthesopathy (M46.07) with sacroiliitis (M46.1) — sacroiliitis targets the SI joint itself, not the ligamentous/muscular spinal attachments.
Using the unspecified parent M46.00 when the provider has clearly documented lumbosacral region — the billable specificity of M46.07 is available and required.
Failing to code the underlying inflammatory spondyloarthropathy when it drives the enthesopathy, leaving the clinical picture incomplete for payer review.
Mixing up M46.07 with M48.07 (spinal stenosis, lumbosacral region) — these are distinct pathologies that may coexist but require separate codes.

Clinical context

Source · Editorial summary grounded in 4 cited references ↓

Use M46.07 when documentation explicitly localizes spinal enthesopathy to the lumbosacral region. The parent code M46.0 establishes that spinal enthesopathy covers disorders of ligamentous or muscular attachments of the spine; the seventh character '7' narrows that to the lumbosacral site. Do not use M46.07 for pure lumbar-region pathology (L1–L5) — that is M46.06. If the provider documents enthesopathy spanning both regions without specifying a dominant site, consider M46.09 (multiple sites in the spine).

M46.07 sits within the Other Inflammatory Spondylopathies block (M45–M49) and groups to MS-DRG 551 (medical back problems with MCC) or 552 (without MCC). It is commonly seen in the setting of spondyloarthropathy, ankylosing spondylitis, psoriatic arthritis, or reactive arthritis when entheseal involvement is documented at the lumbosacral junction. If an underlying inflammatory arthropathy drives the enthesopathy, code the underlying condition as appropriate and sequence accordingly.

Do not confuse M46.07 with M46.1 (sacroiliitis, NEC), which targets the sacroiliac joint proper rather than the entheseal attachments of the lumbosacral spine. Similarly, lumbosacral disc disorders code to the M51.x range, and lumbosacral spinal stenosis codes to M48.07 — separate clinical entities even when they coexist.

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

M46.03

Spinal enthesopathy, cervicothoracic region

M46.08

Spinal enthesopathy, sacral and sacrococcygeal region

Frequently asked questions

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

01What is the difference between M46.07 and M46.06?

M46.06 covers spinal enthesopathy limited to the lumbar region (L1–L5). M46.07 applies when enthesopathy is documented at the lumbosacral junction — the transitional zone between the lumbar spine and sacrum. Use the code that matches the provider's documented site.

02Can M46.07 be used for enthesopathy associated with ankylosing spondylitis?

Yes, but also code the underlying ankylosing spondylitis (M45.x with appropriate regional specificity). M46.07 captures the enthesopathy finding; it does not replace the systemic diagnosis code.

03How does M46.07 differ from M46.1 (sacroiliitis, NEC)?

M46.1 targets inflammatory pathology within the sacroiliac joint itself. M46.07 addresses disordered ligamentous or muscular attachments along the lumbosacral spine. Both may coexist in spondyloarthropathy; code both when documented.

04Is imaging required to bill M46.07?

ICD-10-CM does not mandate imaging for code assignment, but payers frequently require supporting documentation for enthesopathy diagnoses. MRI showing bone marrow edema at entheseal insertion sites or CT demonstrating erosions at the lumbosacral junction strengthens medical necessity.

05Which MS-DRGs does M46.07 map to?

M46.07 groups to MS-DRG 551 (medical back problems with MCC) or MS-DRG 552 (medical back problems without MCC) under MS-DRG v43.0.

06Should M46.07 or M48.07 be used for lumbosacral spinal stenosis with ligamentous hypertrophy?

Use M48.07 for spinal stenosis of the lumbosacral region. M46.07 is reserved for enthesopathy — pathological change at ligament or muscle attachment sites. If both conditions are documented and clinically distinct, assign both codes.

07What happens if the provider documents 'lumbosacral enthesopathy' without further detail — is M46.07 appropriate?

Yes. 'Lumbosacral region' is an accepted synonym for M46.07 per the ICD-10-CM Tabular List. That phrasing maps directly to this code without requiring additional specificity.

Sources & references

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

01CDC ICD-10-CM Tabular List 2026 (effective October 1, 2025)
02
icd10data.com
https://www.icd10data.com/ICD10CM/Codes/M00-M99/M45-M49/M46-/M46.07
03
aapc.com
https://www.aapc.com/codes/icd-10-codes/M46.07
04
cms.gov
https://www.cms.gov/medicare/coding/icd10/downloads/icd10clinicalconceptsorthopedics1.pdf

Mira AI Scribe

Mira AI Scribe captures the provider's explicit localization to the lumbosacral junction, any imaging findings (MRI entheseal edema, CT erosions or enthesophytes at ligament insertion sites), and the presence of an underlying inflammatory condition — preventing a drop to the unspecified M46.00 or mismapping to the lumbar-only M46.06, either of which can trigger a payer specificity audit or reduced reimbursement.

See how Mira captures M46.07 documentation