A bone spur (osteophyte) arising from the right iliac crest, classified as a lower-limb enthesopathy under the M76 category for soft tissue disorders of the hip region.
Verified May 8, 2026 · 4 sources ↓
- Status
- Billable
- Chapter
- 13
- Related CPT
- 5
- Region
- Hip
Documentation tips
What should appear in the chart to support M76.21.
Source · Editorial brief grounded in 4 cited references ↓
- Explicitly name the side — 'right iliac crest spur' — in the assessment; laterality is required to support M76.21 over the unspecified M76.20.
- Reference the imaging study (X-ray, CT, or MRI) that visualizes the spur, including the modality and date, to substantiate the enthesopathy diagnosis.
- Document the clinical presentation: point tenderness over the right iliac crest, aggravating activities, and duration of symptoms to support medical necessity.
- If conservative treatment has been trialed (NSAIDs, physical therapy, corticosteroid injection), note it — payers commonly require documented failure of conservative care before authorizing advanced imaging or procedures.
- Distinguish the iliac crest spur from iliac bursitis in the note; conflating the two can lead to wrong-code assignment and audit exposure.
Related CPT procedures
Procedure codes commonly billed with M76.21. 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 M76.21 and adjacent codes.
Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓
- Defaulting to M76.20 (unspecified hip) when the operative report or imaging clearly documents the right side — always capture the specificity the documentation supports.
- Using M76.21 to code iliac bursitis or soft-tissue inflammation without radiographic evidence of a bony spur; bursitis maps to the M70.- category, not M76.2.
- Failing to report both M76.21 and M76.22 when bilateral spurs are documented — no single bilateral code exists at this level, so two codes are required.
- Confusing iliac crest spur (M76.21) with calcaneal spur (M77.3); the anatomical site must be confirmed before code selection.
Clinical context
Source · Editorial summary grounded in 4 cited references ↓
M76.21 is the billable code for a bony outgrowth at the superior margin of the right iliac crest. Iliac crest spurs form at tendon and ligament attachment sites — the enthesis — where repetitive mechanical stress or chronic traction stimulates reactive bone formation. They appear on plain radiographs and CT as cortical projections along the crest and may cause localized pain, tenderness to palpation, and occasionally referred discomfort into the lateral hip or flank.
Use M76.21 when the provider explicitly documents the spur on the right side. If laterality is not specified, drop to M76.20 (unspecified hip). For a confirmed left-sided spur, use M76.22. If both crests are involved, you may need to report M76.21 and M76.22 together — there is no single bilateral code at the 5th-character level within M76.2.
M76.21 falls under the M76 enthesopathy block, which carries a Type 2 Excludes note for bursitis due to use, overuse, and pressure (M70.-) and enthesopathies of the ankle and foot (M77.5-). Do not use M76.21 to capture iliac bursitis; that requires a separate code. The code maps to MS-DRG 557/558 (Tendonitis, Myositis and Bursitis with/without MCC) for inpatient grouping purposes.
Sibling codes
Other billable codes under M76.2 (laterality / anatomic variants).
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 4 cited references ↓
01Is M76.21 a billable code for FY2026?
02What code do I use if the spur is on the left iliac crest instead?
03Can I bill M76.21 for bilateral iliac crest spurs?
04Does M76.21 require imaging confirmation, or can it be coded from clinical exam alone?
05What MS-DRG does M76.21 map to for inpatient encounters?
06Is iliac crest spur the same as iliac bursitis, and do they share a code?
07What is the parent code for M76.21, and when would I use it instead?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
Mira AI Scribe
Mira's AI scribe captures laterality (right), the imaging source confirming the bony spur, point-tenderness location over the iliac crest, and any prior conservative treatment from the encounter note. This prevents downcoding to M76.20 (unspecified) and removes the audit risk of an unsupported enthesopathy claim.
See how Mira captures M76.21 documentation