ICD-10-CM · Spine

M47.26

Degenerative spinal disease of the lumbar vertebrae (arthrosis, osteophyte formation, facet joint degeneration) producing documented nerve root compression or irritation — radiculopathy — localized to the lumbar region.

Verified May 8, 2026 · 6 sources ↓

Status
Billable
Chapter
13
Related CPT
15
Region
Spine
Drawn from CDCICD10DataAAPCOutsourcestrategiesIcdcodes

Documentation tips

What should appear in the chart to support M47.26.

Source · Editorial brief grounded in 6 cited references ↓

  • Explicitly name the diagnosis as 'lumbar spondylosis with radiculopathy' — terms like 'lumbar DDD with leg pain' are insufficient without the word radiculopathy or a dermatomal description.
  • Record the specific nerve root(s) implicated (e.g., L4, L5, S1) and the corresponding dermatomal distribution of symptoms to support medical necessity.
  • Document imaging findings that correlate with radiculopathy: foraminal stenosis, osteophyte encroachment on nerve root canal, or disc-osteophyte complex on MRI or CT.
  • Distinguish myelopathy from radiculopathy in the note — if long-tract signs (gait instability, hyperreflexia, Babinski) are absent, state that explicitly to support M47.26 over M47.16.
  • If both the lumbar and lumbosacral segments are involved, specify the primary level to determine whether M47.26 (lumbar) or M47.27 (lumbosacral) is the correct code — do not use both for the same nerve root.

Related CPT procedures

Procedure codes commonly billed with M47.26. 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.
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.
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.
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.
99215 $192.39
Highest-level office or outpatient E/M visit for an established patient, qualifying via high-complexity medical decision making or 40–54 minutes of total provider time on the date of service.
27096 $175.69
Injection into the sacroiliac joint with fluoroscopic or CT image guidance, including arthrography when performed.
72149 View procedure details
62323 View procedure details
62321 View procedure details
64483 View procedure details
64484 View procedure details
97012 View procedure details

Common coding pitfalls

The recurring mistakes coders make with M47.26 and adjacent codes.

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

  • Coding M47.26 when the documented etiology of radiculopathy is a herniated disc rather than spondylosis — disc-mediated radiculopathy belongs under M51.16, not M47.26.
  • Using M54.16 (radiculopathy, lumbar region) alongside M47.26 — the Tabular List excludes M54.16 when spondylosis with radiculopathy is already coded, making dual-coding an audit risk.
  • Dropping to M47.20 (site unspecified) when the lumbar region is documented — always assign the most specific site code available.
  • Assigning M47.26 based on imaging findings of spondylosis alone without a clinical diagnosis of radiculopathy — degeneration visible on MRI does not equal radiculopathy for coding purposes.
  • Confusing lumbar (M47.26) with lumbosacral (M47.27) — if the pathology is at L5-S1 and the provider documents lumbosacral involvement, M47.27 is correct.
  • Selecting M47.16 (myelopathy) when the note describes radiculopathy — these are mutually exclusive categories; the distinction must be driven by the clinical documentation, not coder inference.

Clinical context

Source · Editorial summary grounded in 6 cited references ↓

M47.26 applies when lumbar spondylosis — degenerative disc changes, osteophyte formation, or facet arthrosis — produces radiculopathy: dermatomal pain, numbness, tingling, or motor weakness radiating into the lower extremity. The radiculopathy must be explicitly documented by the treating provider; a diagnosis of nonspecific low back pain does not support this code.

Critical distinction: if the encounter involves myelopathy (cord compression with long-tract signs) rather than radiculopathy, use M47.16 (other spondylosis with myelopathy, lumbar region). If pathology extends to the lumbosacral junction, M47.27 (lumbosacral region) may be more precise. When radiculopathy is caused by intervertebral disc disease rather than spondylosis, M51.16 (intervertebral disc disorder with radiculopathy, lumbar region) is the correct parent — spondylosis and disc disorders are distinct etiologies under ICD-10-CM.

M47.26 is billable and specific; no additional 7th-character extension is required. It sits under parent M47.2 (other spondylosis with radiculopathy), which is not itself billable. When symptoms also include isolated lumbar radiculopathy without a confirmed structural etiology, M54.16 (radiculopathy, lumbar region) is excluded from use alongside M47.26 — the spondylosis code already captures the radicular component.

Sibling codes

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

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What is the difference between M47.26 and M54.16?
M47.26 specifies the etiology — spondylosis causing radiculopathy. M54.16 codes radiculopathy without identifying a structural cause. Per ICD-10-CM tabular instruction, M54.16 is excluded when M47.26 is used; do not report both.
02When should I use M47.27 (lumbosacral) instead of M47.26 (lumbar)?
Use M47.27 when the provider documents lumbosacral involvement or when pathology is centered at the L5-S1 segment and described as lumbosacral. M47.26 is correct for L1-L5 level disease. If the note is ambiguous, query the provider before assigning.
03Can M47.26 and M51.16 be coded together?
Generally no for the same nerve root at the same level — if disc herniation is the cause of radiculopathy, M51.16 is the correct code. If both spondylotic and discogenic pathology are documented at different levels contributing to radiculopathy, dual coding may be appropriate, but require provider documentation supporting both etiologies.
04Does M47.26 require a 7th-character extension?
No. M47.26 is a 5-character M-code and does not use 7th-character extensions. The A/D/S encounter designators apply to injury codes (S-codes), not degenerative musculoskeletal diagnoses.
05What imaging is needed to support M47.26?
MRI or CT demonstrating foraminal stenosis, osteophyte encroachment on a nerve root canal, or a disc-osteophyte complex at the lumbar level is standard support. The code is clinically driven — imaging must correlate with documented radicular symptoms.
06Is M47.26 appropriate for a patient with sciatica caused by lumbar spondylosis?
Yes, if the provider explicitly diagnoses lumbar spondylosis with radiculopathy as the cause of sciatica symptoms. The sciatica code (M54.4x) is not reported separately when the etiology is captured by M47.26.
07What CPT procedures most commonly pair with M47.26?
Lumbar MRI (72148/72158), epidural steroid injections (62323, 64483-64484), physical therapy (97110, 97012), and E&M visits (99213-99215) are typical pairings. Surgical codes like laminectomy or foraminotomy may also link when conservative care has failed.

Mira AI Scribe

Mira captures the dermatomal distribution of symptoms (e.g., pain radiating from lumbar spine into posterior thigh or below the knee), the specific nerve root level, imaging findings confirming foraminal stenosis or osteophyte-nerve root contact, and the absence of myelopathic signs — preventing a downcode to M47.20 (unspecified site) or a mismatch with M47.16 (myelopathy) that triggers payer audit.

See how Mira captures M47.26 documentation

Related ICD-10 codes

Ready?

Ready to transform your orthopedic practice?

See how orthopedic practices are running documentation, billing, and operations on a single voice-first platform.

Get started for free