M76.22 identifies an osseous spur formation along the superior rim of the left iliac crest at the tendon or fascia attachment site, classified as a lower-limb enthesopathy.

Documentation tips

What should appear in the chart to support M76.22.

Source · Editorial brief grounded in 6 cited references ↓

• Explicitly state 'left iliac crest spur' or 'left-sided iliac crest enthesophyte' — do not rely on imaging reports alone; the provider's assessment must name the side.
• Record the imaging modality and finding that confirms the spur: e.g., 'AP pelvis radiograph demonstrates a calcific enthesophyte along the left iliac crest at the external oblique/gluteal attachment.'
• Document the functional impact: point tenderness over the left iliac crest, pain with hip abduction or trunk lateral flexion, or exacerbation with activity — supporting medical necessity for treatment or imaging orders.
• Note any prior conservative treatment (NSAIDs, physical therapy, corticosteroid injection) if billing for advanced imaging or procedural intervention, to establish necessity.
• If bilateral iliac crest spurs are confirmed, report M76.21 and M76.22 together; do not use M76.20 when both sides are documented.

Related CPT procedures

Procedure codes commonly billed with M76.22. 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 M76.22 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 chart clearly names the left side — this downcodes specificity and can trigger payer audits.
• Confusing iliac crest spur (M76.22) with trochanteric bursitis (M70.62) or gluteal tendinitis (M76.02); each has a distinct attachment site and requires separate clinical documentation.
• Coding M76.22 without imaging or provider-confirmed diagnosis — bony spurs must be objectively supported, not inferred from pain location alone.
• Overlooking the Excludes2 note at M76 and failing to separately report coexisting bursitis (M70.-) when both conditions are documented and treated.

Clinical context

Source · Editorial summary grounded in 6 cited references ↓

Sibling codes

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