M76.20 identifies a bony spur formation at the iliac crest with laterality not documented or not specified — classified as an enthesopathy of the lower limb under the M76 category.

Documentation tips

What should appear in the chart to support M76.20.

Source · Editorial brief grounded in 6 cited references ↓

• Explicitly name the affected side (right or left) in every note — 'iliac crest spur' without laterality forces M76.20 and blocks CMS injection medical-necessity coverage.
• Record imaging findings that confirm the spur: plain film or CT showing cortical projection at the iliac crest, including size if documented.
• Document the symptom location and any referred pain pattern to distinguish iliac crest enthesopathy from hip joint pathology or gluteal tendinitis.
• If conservative care has been tried (PT, NSAIDs, corticosteroid injection), list each modality and duration to support medical necessity for advanced treatment.
• When multiple enthesopathies coexist (e.g., psoas tendinitis plus iliac crest spur), document each separately so distinct codes can be assigned.

Related CPT procedures

Procedure codes commonly billed with M76.20. 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 M76.20 and adjacent codes.

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

• Billing M76.20 for injection procedures: CMS's pain management draft article excludes the unspecified code — claims will deny without M76.21 or M76.22.
• Confusing iliac crest enthesopathy with hip joint osteophyte (M25.75x) — the spur here is at a muscle or ligament attachment on the iliac crest, not within or adjacent to the hip joint itself.
• Using the parent non-billable code M76.2 instead of the required 5th-character billable code M76.20, M76.21, or M76.22 — payers will reject M76.2 as non-specific.
• Coding M76.20 when the record clearly documents a unilateral finding — even verbal shorthand like 'right-sided hip pain with iliac crest spur on imaging' is sufficient to justify M76.21.

Clinical context

Source · Editorial summary grounded in 6 cited references ↓

Sibling codes

Other billable codes under M76.2 (laterality / anatomic variants).