ICD-10-CM · Spine

M46.52

Infectious inflammation of the vertebrae and surrounding spinal structures localized to the cervical (C1–C7) region, caused by a pathogen other than tuberculosis or brucellosis.

Verified May 8, 2026 · 4 sources ↓

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

Drawn from CDCCMSAAPCICD

Documentation tips

What should appear in the chart to support M46.52.

Source · Editorial brief grounded in 4 cited references ↓

Specify 'cervical region' or the exact vertebral level(s) affected (e.g., C4–C5) — the code is not valid without regional localization.
Record the causative organism by name and source (blood culture, biopsy, wound swab) so a secondary organism code can be assigned.
Document MRI findings explicitly: marrow signal change, endplate erosion, disc space involvement, or paraspinal/epidural abscess.
Note whether infection is post-procedural, hematogenous, or from direct extension, as this affects sequencing and potential complications coding.
Record ESR, CRP, and WBC values with dates — laboratory evidence of active infection strengthens medical necessity documentation.
If conservative antibiotic management has failed, document the duration and agents trialed to support surgical or SCS authorization.

Related CPT procedures

Procedure codes commonly billed with M46.52. Linking the right diagnosis to the right procedure is what establishes medical necessity.

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

22590 $1,559.15

Posterior arthrodesis of the craniocervical junction, spanning from the occiput through C2, performed to eliminate pathologic motion at the skull-cervical interface.

22595 $1,499.03

Posterior arthrodesis of the atlas and axis (C1-C2), surgically fusing the first and second cervical vertebrae through a posterior approach to stabilize the upper cervical spine.

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.

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.

63001 $1,193.75

Posterior cervical laminectomy covering 1 or 2 vertebral segments, performed to decompress the spinal cord or cauda equina, without facetectomy, foraminotomy, or discectomy.

63015 $1,444.59

Cervical laminectomy spanning more than two vertebral segments for spinal cord or cauda equina exploration and/or decompression, performed without facetectomy, foraminotomy, or discectomy.

63045 $1,249.53

Open cervical laminectomy with facetectomy and foraminotomy at a single vertebral level to decompress nerve roots or the spinal cord.

72141 $190.72

MRI of the cervical spinal canal and its contents performed without contrast material.

72156 View procedure details

77080 View procedure details

Common coding pitfalls

The recurring mistakes coders make with M46.52 and adjacent codes.

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

Assigning M46.52 without a secondary organism code when the pathogen is identified — always add B95–B97 or A-series codes for the causative agent.
Using M46.52 for tuberculous spondylitis — tuberculosis of the spine maps to A18.01, not M46.5x, regardless of cervical location.
Defaulting to M46.50 (site unspecified) when the record clearly states cervical involvement — this loses specificity and can trigger audit flags.
Confusing M46.52 (infective spondylopathy) with M46.42 (discitis, cervical) — discitis is disc-space-specific; spondylopathy involves the vertebral body and broader spinal structures.
Omitting the secondary procedure code for imaging (e.g., MRI cervical spine) when submitting for SCS medical necessity review — payers cross-reference diagnostic workup.

Clinical context

Source · Editorial summary grounded in 4 cited references ↓

M46.52 applies when an infectious process — bacterial, fungal, viral, or parasitic — is attacking the cervical spine and the causative organism does not fall under a more specific code (e.g., A18.01 for spinal TB). Common clinical scenarios include pyogenic cervical vertebral osteomyelitis spreading to adjacent structures, post-procedural cervical spine infection, or hematogenous seeding of cervical vertebrae from a remote source. The diagnosis requires imaging confirmation (typically MRI showing marrow edema, endplate destruction, or paraspinal abscess) plus laboratory evidence of infection.

Use M46.52 for the cervical region specifically (C1–C7). If the infection spans the cervicothoracic junction, M46.53 is the correct pick. If the site is undocumented or the infection involves multiple spinal regions, use M46.50 (site unspecified) or M46.59 (multiple sites) respectively. Always code the causative organism as a secondary code when identified — for example, B95.61 for Staphylococcus aureus or B96.xx for other bacterial agents.

CMS recognizes M46.52 as a covered diagnosis supporting medical necessity for spinal cord stimulators when chronic intractable pain results from the infection or its sequelae (CMS Article A57792). Accurate coding of the cervical region is therefore directly relevant to SCS authorization workflows, in addition to standard surgical and antibiotic management billing.

Sibling codes

Other billable codes under M46.5 (laterality / anatomic variants).

M46.53

Other infective spondylopathies, cervicothoracic region

M46.51

Oth infective spondylopathies, occipito-atlanto-axial region

M46.55

Other infective spondylopathies, thoracolumbar region

M46.59

Other infective spondylopathies, multiple sites in spine

M46.58

Oth infective spondylopathies, sacr/sacrocygl region

M46.50

Other infective spondylopathies, site unspecified

M46.54

Other infective spondylopathies, thoracic region

M46.57

Other infective spondylopathies, lumbosacral region

Frequently asked questions

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

01What is the difference between M46.52 and M46.42?

M46.42 is discitis of the cervical region — an infection primarily in the intervertebral disc space. M46.52 is a broader infective spondylopathy involving the vertebral body and surrounding structures. If imaging shows both disc and vertebral body involvement, query the provider; M46.52 is typically the more appropriate code when vertebral involvement is confirmed.

02Should I code the causative organism separately when using M46.52?

Yes. ICD-10-CM instructs coders to use an additional code from B95–B97 (or the appropriate A-series code) to identify the infectious agent whenever the organism is documented. For example, add B95.61 for methicillin-susceptible Staphylococcus aureus.

03Can M46.52 be used for tuberculous cervical spondylitis (Pott's disease)?

No. Tuberculosis of the spine codes to A18.01 regardless of the spinal region affected. M46.52 is explicitly for infective spondylopathies other than tuberculosis and brucellosis.

04Does M46.52 support medical necessity for spinal cord stimulator implantation?

Yes. CMS Billing and Coding Article A57792 lists M46.52 among the ICD-10-CM codes that support medical necessity for spinal cord stimulators for chronic pain. Ensure the clinical record documents chronic intractable cervical pain refractory to conservative management.

05Which code do I use if the infection spans both the cervical and thoracic spine?

Use M46.53 (Other infective spondylopathies, cervicothoracic region) when the infection straddles the cervicothoracic junction. If multiple non-contiguous spinal regions are involved, use M46.59 (multiple sites).

06Is imaging required to assign M46.52?

ICD-10-CM does not require imaging as a coding rule, but payers — especially for surgical or SCS authorization — expect MRI or CT evidence of vertebral infection. Document imaging findings explicitly to defend the diagnosis on audit.

07Can M46.52 be a principal diagnosis on a hospital claim?

Yes, when the infective cervical spondylopathy is the condition chiefly responsible for the admission after study. Sequence it first, then add the organism code and any complication codes (e.g., G06.1 for intraspinal abscess) as secondary diagnoses.

Sources & references

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

01CDC ICD-10-CM Tabular List 2026 (FY2026, effective Oct 1, 2025)
02CMS Billing and Coding Article A57792: Spinal Cord Stimulators for Chronic Pain — https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57792
03AAPC Codify ICD-10-CM M46.52 — https://www.aapc.com/codes/icd-10-codes/M46.52
04ICD10Data.com M46.52 — https://www.icd10data.com/ICD10CM/Codes/M00-M99/M45-M49/M46-/M46.52

Mira AI Scribe

Mira AI Scribe captures cervical region localization, MRI findings (endplate erosion, marrow edema, epidural involvement), organism identified on culture, lab values (ESR/CRP), and history of prior antibiotic therapy from the encounter note. Precise capture prevents downgrade to M46.50 (site unspecified), ensures the organism secondary code is flagged, and supports SCS or surgical authorization that requires documented cervical-region infection.

See how Mira captures M46.52 documentation