ICD-10-CM · Spine

M47.25

Degenerative spinal disease at the thoracolumbar junction (T12–L1 region) with documented nerve root compression producing radicular symptoms.

Verified May 8, 2026 · 5 sources ↓

Status: Billable
Chapter: 13
Related CPT: 15
Region: Spine

Drawn from CDCICD10DataAAPCOutsourcestrategiesCMS

Documentation tips

What should appear in the chart to support M47.25.

Source · Editorial brief grounded in 5 cited references ↓

Specify 'thoracolumbar region' or identify the T12–L1 level by name — generic 'mid-back' or 'lower thoracic' is insufficient to lock in M47.25 over adjacent codes.
Document radiculopathy explicitly: dermatomal pain pattern, sensory deficits, or motor findings — not just 'radiating pain,' which could support only M54.x.
Correlate imaging findings (MRI or CT) to the clinical picture: foraminal stenosis, osteophytic encroachment on the nerve root, or disc-osteophyte complex at the thoracolumbar junction.
If both myelopathy and radiculopathy are present, document which is the primary neurological deficit; myelopathy tips the code to M47.15, not M47.25.
Record prior conservative care (PT, injections, NSAIDs) when this code is used to support surgical or interventional authorization — payers frequently require it for procedures at this level.

Related CPT procedures

Procedure codes commonly billed with M47.25. Linking the right diagnosis to the right procedure is what establishes medical necessity.

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

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.

72020 $23.71

Single-view radiologic examination of the spine at a specified level.

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.

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.

22533 $1,547.80

Spinal fusion of a lumbar vertebral segment performed through a lateral extracavitary approach, including minimal discectomy to prepare the interspace (not performed solely for decompression).

22534 $323.65

Add-on code for lateral extracavitary arthrodesis at each additional thoracic or lumbar vertebral segment beyond the first.

22558 $1,423.88

Anterior interbody arthrodesis of the lumbar spine using an anterior or anterolateral approach, including the minimal discectomy required to prepare the interspace for fusion.

62321 View procedure details

64493 View procedure details

64494 View procedure details

64495 View procedure details

97014 View procedure details

Common coding pitfalls

The recurring mistakes coders make with M47.25 and adjacent codes.

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

Assigning M47.25 when the documented level is purely thoracic (T4–T12) — that maps to M47.24, not M47.25.
Using M47.25 when the documented level is purely lumbar (L1–L5) — that maps to M47.26.
Confusing radiculopathy (M47.25) with myelopathy (M47.15) — both involve thoracolumbar spondylosis, but cord involvement versus nerve root involvement drives a different code and a different clinical pathway.
Defaulting to M47.20 (site unspecified) when the operative or imaging report clearly documents the thoracolumbar junction — specificity is available and should be used.
Failing to add a secondary symptom code (e.g., M54.16 for lumbar radiculopathy symptoms) when the payer or clinical protocol requires it alongside the spondylosis code.

Clinical context

Source · Editorial summary grounded in 5 cited references ↓

M47.25 applies when spondylosis — degenerative changes including facet joint osteoarthritis, disc degeneration, and osteophyte formation — is localized to the thoracolumbar region and is causing radiculopathy. The thoracolumbar junction (approximately T12–L1) is a biomechanically stressed transition zone between the relatively rigid thoracic spine and the mobile lumbar spine. Radiculopathy at this level typically produces dermatomal symptoms in the upper lumbar distribution, including anterior thigh, groin, or flank pain.

The 'other spondylosis' qualifier distinguishes M47.25 from anterior spinal artery compression (M47.0x) and from spondylosis with myelopathy (M47.15). If the dominant neurological deficit is spinal cord involvement rather than nerve root involvement, use M47.15 instead. If radiculopathy is present but the exact spinal region is not documented, fall back to M47.20 (site unspecified) — but that will invite scrutiny; get the region documented.

M47.25 sits within the M47.2 subcategory (Other spondylosis with radiculopathy), which spans the full spine from occipito-atlanto-axial (M47.21) through sacral (M47.28). Adjacent codes for the thoracolumbar region include M47.15 (myelopathy) and M47.815 (without myelopathy or radiculopathy). Choose based strictly on what the clinician documents — radiculopathy, myelopathy, or neither.

Sibling codes

Other billable codes under M47.2 (laterality / anatomic variants).

M47.20

Other spondylosis with radiculopathy, site unspecified

M47.22

Other spondylosis with radiculopathy, cervical region

M47.26

Other spondylosis with radiculopathy, lumbar region

M47.23

Other spondylosis with radiculopathy, cervicothoracic region

M47.21

Oth spondylosis w radiculopathy, occipt-atlan-ax region

M47.28

Oth spondylosis w radiculopathy, sacr/sacrocygl region

M47.27

Other spondylosis with radiculopathy, lumbosacral region

M47.24

Other spondylosis with radiculopathy, thoracic region

Frequently asked questions

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

01What is the thoracolumbar region for ICD-10-CM coding purposes?

The thoracolumbar region refers to the junction of the thoracic and lumbar spine, generally the T12–L1 vertebral level. Pathology documented at this junction — not purely thoracic and not purely lumbar — belongs in the thoracolumbar subcategories of M47.

02Can I use M47.25 alongside a separate radiculopathy code like M54.16?

Yes. M47.25 identifies the structural diagnosis (spondylosis with radiculopathy at the thoracolumbar level). Some payers and clinical protocols require an additional symptom-level code; M54.16 (radiculopathy, lumbar region) or M54.14 (radiculopathy, thoracic region) may be appended when the radicular symptom pattern is in that distribution, but verify payer policy before adding it to avoid duplication flags.

03What separates M47.25 from M47.15?

M47.15 is other spondylosis with myelopathy at the thoracolumbar region — cord involvement. M47.25 is the same region with radiculopathy — nerve root involvement. The clinical distinction (long tract signs vs. dermatomal radicular pattern) must be documented to support the correct code.

04What if the clinician documents spondylosis at both the thoracic and thoracolumbar levels?

Assign separate codes for each documented region. M47.24 covers the thoracic region and M47.25 covers the thoracolumbar region. Both are billable when supported by documentation and imaging at each respective level.

05Does M47.25 require imaging confirmation to be billable?

ICD-10-CM does not mandate imaging for code assignment, but payers — particularly for interventional procedures like epidural steroid injections or surgical authorization — typically require MRI or CT correlation showing nerve root compromise at the thoracolumbar junction. Document imaging findings in the note to withstand audit.

06When should I use M47.20 instead of M47.25?

Use M47.20 (site unspecified) only when the treating clinician has not documented or cannot identify the spinal region involved. If the note, operative report, or imaging report identifies the thoracolumbar junction, M47.25 is the correct code and M47.20 is a downcode that may reduce medical necessity support.

07Is M47.25 valid for physical therapy and pain management claims, not just surgical claims?

Yes. M47.25 is a billable code valid across care settings — PT, pain management, chiropractic, and surgical. Ensure the treating provider's documentation ties the functional limitation or intervention directly to the thoracolumbar spondylosis with radiculopathy to support necessity at each encounter.

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/M47-/M47.25
03
aapc.com
https://www.aapc.com/codes/icd-10-codes/M47.25
04
outsourcestrategies.com
https://www.outsourcestrategies.com/blog/icd-10-codes-for-documenting-spondylosis-a-degenerative-condition/
05
cms.gov
https://www.cms.gov/files/document/fy-2025-icd-10-cm-coding-guidelines.pdf

Mira AI Scribe

The Mira AI Scribe captures the spinal level (T12–L1 or 'thoracolumbar junction'), the nature of neurological involvement (dermatomal pain, paresthesia, sensory or motor deficit), and the imaging findings (foraminal stenosis, osteophyte, disc-osteophyte complex) from the encounter note. This prevents a downcode to M47.20 (site unspecified) or a misroute to M47.24 (thoracic) or M47.26 (lumbar), either of which can trigger a medical necessity denial for injections or surgical authorization at the thoracolumbar level.

See how Mira captures M47.25 documentation