M47.23 identifies degenerative spine disease (spondylosis) at the cervicothoracic junction — the C7-T1 transition zone — accompanied by documented nerve root compression producing radiculopathy.
Verified May 8, 2026 · 5 sources ↓
- Status
- Billable
- Chapter
- 13
- Related CPT
- 20
- Region
- Spine
Documentation tips
What should appear in the chart to support M47.23.
Source · Editorial brief grounded in 5 cited references ↓
- Explicitly name the cervicothoracic region (C7-T1) in the assessment — generic 'cervical spine' documentation does not satisfy the regional specificity required for M47.23.
- Document that radiculopathy is caused by the spondylotic changes, not by a discrete herniated disc; if both exist, the provider must state which is the primary driver of nerve root compression.
- Record imaging findings that confirm degenerative changes at C7-T1: osteophyte formation, foraminal stenosis, facet arthropathy, or end-plate sclerosis — Kellgren-Lawrence grade or MRI descriptor if available.
- Include the radicular distribution (e.g., C8 dermatomal pattern: medial forearm, ring and small finger numbness or weakness) to corroborate the cervicothoracic level.
- Note any prior conservative management (physical therapy, medications, injections) as payers frequently require this history before authorizing interventional procedures billed alongside this diagnosis.
Related CPT procedures
Procedure codes commonly billed with M47.23. Linking the right diagnosis to the right procedure is what establishes medical necessity.
Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis
Common coding pitfalls
The recurring mistakes coders make with M47.23 and adjacent codes.
Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓
- Assigning M47.23 when imaging reveals a herniated disc as the cause of radiculopathy — use M50.13 instead; spondylosis codes presuppose degenerative bony/facet pathology, not disc herniation.
- Using M47.23 for mid-cervical radiculopathy (C4-C6 levels) — that region maps to M47.22, not M47.23; match the code to the documented anatomical level.
- Coding radiculopathy as a separate standalone code (e.g., M54.12) when M47.23 already incorporates radiculopathy — doing so creates a redundant, potentially conflicting code pair.
- Selecting M47.23 based on the patient's symptom complaint rather than confirmed spondylosis diagnosis — radicular arm or shoulder symptoms without documented C7-T1 structural pathology do not support this code.
- Confusing the cervicothoracic region with the thoracic region: M47.23 is C7-T1; thoracic spondylosis with radiculopathy maps to M47.24.
Clinical context
Source · Editorial summary grounded in 5 cited references ↓
Use M47.23 when the treating provider documents spondylosis with radiculopathy specifically at the cervicothoracic region (C7-T1 junction). The radiculopathy must be causally linked to the spondylotic process — not attributed to a discrete disc herniation, which maps instead to M50.13 (cervical disc disorder with radiculopathy, cervicothoracic region). The distinction matters: if imaging shows both degenerative facet/end-plate changes and a herniated disc compressing a nerve root, the provider must document which pathology is driving the radicular symptoms before you select between M47.23 and M50.13.
The cervicothoracic region designation in ICD-10-CM refers to the C7-T1 segment. If the radiculopathy originates higher in the cervical spine (C2-C6), the correct parent-level specificity shifts to M47.22 (mid-cervical) or M47.21 (occipito-atlanto-axial). If it extends into the thoracic or lumbar segments, different 5th-character variants apply. Never assign M47.23 based on a complaint of 'neck and upper back pain' alone — the chart must support both the spondylotic structural finding and the radicular component.
M47.23 groups under MS-DRG v43.0 DRGs 551 (Medical back problems with MCC) and 552 (Medical back problems without MCC). The code is valid for all payer types for dates of service on or after October 1, 2015, and has had no revisions through the FY2026 effective date of October 1, 2025.
Sibling codes
Other billable codes under M47.2 (laterality / anatomic variants).
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 5 cited references ↓
01What distinguishes M47.23 from M50.13?
02Does M47.23 require a separate radiculopathy code?
03Which anatomical levels define the cervicothoracic region for ICD-10-CM coding purposes?
04Can M47.23 be a primary diagnosis for interventional pain procedures like epidural steroid injections?
05What MS-DRGs does M47.23 group to under Medicare?
06Is M47.23 valid for outpatient physical therapy claims?
07Should M47.23 be used if the patient also has cervical myelopathy?
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)
- 02icd10data.comhttps://www.icd10data.com/ICD10CM/Codes/M00-M99/M45-M49/M47-/M47.23
- 03aapc.comhttps://www.aapc.com/codes/icd-10-codes/M47.23
- 04cms.govhttps://www.cms.gov/medicare/coding/icd10/downloads/icd10clinicalconceptsorthopedics1.pdf
- 05stacks.cdc.govhttp://stacks.cdc.gov/view/cdc/158747
Mira AI Scribe
Mira's AI scribe captures the cervicothoracic level (C7-T1), the causal link between degenerative bony changes and nerve root compression, the radicular distribution (dermatomal pattern, affected extremity), and supporting imaging descriptors such as foraminal stenosis or osteophyte grade. This prevents downcoding to a non-specific spondylosis code, avoids conflation with disc herniation codes, and eliminates the audit risk of separately listed redundant radiculopathy codes.
See how Mira captures M47.23 documentation