ICD-10-CM · Hip

M99.25

Narrowing of the neural canal in the pelvic region caused by subluxation — a biomechanical displacement of adjacent structures that mechanically compromises the canal space.

Verified May 8, 2026 · 6 sources ↓

Status: Billable
Chapter: 13
Related CPT: 12
Region: Hip

Drawn from CDCICD10DataAAPCOpscCMS

Documentation tips

What should appear in the chart to support M99.25.

Source · Editorial brief grounded in 6 cited references ↓

Provider must explicitly name the mechanism as subluxation — not degeneration, disc herniation, or bony overgrowth — to support M99.25 over M99.35, M99.45, or M99.55.
Document the pelvic region localization specifically; adjacent regions (sacral = M99.24, lumbar = M99.23) require their own codes.
Include imaging findings (MRI, CT, or plain film) or clinical examination findings that demonstrate neural canal compromise in the pelvic region.
If segmental and somatic dysfunction is also present, code M99.05 (pelvic region) separately — the two are distinct diagnostic categories and may coexist.
Record functional deficits or neurological symptoms (radiculopathy, bowel/bladder changes) as secondary diagnoses to support medical necessity for advanced imaging or therapeutic procedures.

Related CPT procedures

Procedure codes commonly billed with M99.25. Linking the right diagnosis to the right procedure is what establishes medical necessity.

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

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.

72195 $227.46

MRI of the pelvis performed without contrast material, producing soft-tissue images of pelvic structures without intravenous dye administration.

72170 $28.06

Radiologic examination of the pelvis capturing one or two views, used to evaluate pelvic bones, sacrum, and coccyx for fractures, arthritis, or other structural abnormalities.

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.

98940 View procedure details

98941 View procedure details

98942 View procedure details

98943 View procedure details

72197 View procedure details

72196 View procedure details

97530 View procedure details

Common coding pitfalls

The recurring mistakes coders make with M99.25 and adjacent codes.

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

Defaulting to M99.25 for any pelvic neural symptom — the code requires documented canal stenosis with subluxation as the identified mechanism, not just pelvic pain or radiculopathy.
Confusing subluxation stenosis (M99.25) with osseous stenosis (M99.35) or connective tissue stenosis (M99.45) of the pelvic region — the mechanism drives the code, and payer audits can flag mismatched clinical notes.
Using M99.25 when the clinical record actually describes spondylolisthesis-related canal narrowing, which maps to a different code family (M43.1x for spondylolisthesis).
Failing to code co-existing segmental dysfunction (M99.05) separately when both conditions are documented — they are not mutually exclusive and capturing both supports complexity and medical necessity.

Clinical context

Source · Editorial summary grounded in 6 cited references ↓

M99.25 captures subluxation-driven stenosis of the neural canal specifically localized to the pelvic region. It sits under the M99.2 subcategory (Subluxation stenosis of neural canal) within the broader M99 block of biomechanical lesions not elsewhere classified. The distinction from osseous stenosis (M99.35), connective tissue stenosis (M99.45), or intervertebral disc stenosis (M99.55) of the same region is mechanistic: the canal narrowing here is attributed to a subluxation — a positional or motion-segment displacement — rather than bony overgrowth, ligamentous hypertrophy, or disc material.

This code is used most frequently in chiropractic and osteopathic documentation, where subluxation complexes are clinically defined and routinely coded. It may also appear in physiatry or spine specialist records when imaging or clinical examination identifies pelvic-region canal compromise linked to a segmental malalignment rather than a structural degeneration. Always confirm that the provider has explicitly documented subluxation as the mechanism; if the stenosis is attributed to degenerative disc disease or spondylolisthesis, a different code family applies.

M99.25 is a billable, fully specified code — no further subdivision exists for laterality within this subcategory. If the stenosis spans multiple regions, code each affected region separately. Do not use M99.25 as a catch-all for pelvic neural symptoms; it requires documented canal stenosis attributable to subluxation in the pelvic region.

Sibling codes

Other billable codes under M99.2 (laterality / anatomic variants).

M99.21

Subluxation stenosis of neural canal of cervical region

M99.20

Subluxation stenosis of neural canal of head region

M99.27

Subluxation stenosis of neural canal of upper extremity

M99.29

Sublux stenosis of neural canal of abdomen and oth regions

M99.23

Subluxation stenosis of neural canal of lumbar region

M99.22

Subluxation stenosis of neural canal of thoracic region

M99.28

Subluxation stenosis of neural canal of rib cage

M99.24

Subluxation stenosis of neural canal of sacral region

Frequently asked questions

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

01What distinguishes M99.25 from M99.35 (osseous stenosis of neural canal, pelvic region)?

M99.25 requires that the canal narrowing is caused by a subluxation — a biomechanical positional displacement. M99.35 applies when bony overgrowth or osseous change is the primary mechanism. The provider's documented etiology determines which code applies; imaging findings should corroborate the mechanism.

02Can M99.25 be used for chiropractic encounters?

Yes. M99.25 is used in chiropractic and osteopathic billing when subluxation-driven neural canal stenosis in the pelvic region is the documented diagnosis. It commonly appears alongside CPT codes for osteopathic manipulative treatment (98940–98943) or chiropractic spinal manipulation.

03Is there a laterality distinction within M99.25?

No. M99.25 has no laterality subdivisions — it covers the pelvic region as a whole. If bilateral or multi-region involvement is documented, code each distinct region separately (e.g., M99.24 for sacral region, M99.23 for lumbar region).

04Can M99.25 and M99.05 be coded together on the same encounter?

Yes. M99.05 (segmental and somatic dysfunction of pelvic region) and M99.25 are distinct diagnostic categories and can coexist. If both are documented, code both to fully represent the clinical picture and support medical necessity.

05Does M99.25 require imaging to bill?

ICD-10-CM does not mandate imaging as a coding prerequisite, but clinical documentation must support the diagnosis of subluxation stenosis of the neural canal. Imaging (MRI or CT) that demonstrates canal narrowing significantly strengthens the record against a medical necessity challenge.

06When should a coder use M99.25 versus a spondylolisthesis code like M43.16?

If the provider attributes pelvic neural canal stenosis to spondylolisthesis, code M43.16 (spondylolisthesis, lumbar region) or the appropriate site-specific M43.1x code. M99.25 is reserved for subluxation as a biomechanical lesion classified in the M99 block — not degenerative spondylolisthesis, which has its own coding pathway.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the provider's stated mechanism (subluxation), the anatomical region (pelvic), any imaging findings showing canal compromise, and associated neurological symptoms. This prevents the encounter from being coded to an unspecified or mechanistically incorrect stenosis code — which risks payer downcoding or a medical necessity audit when high-value services like MRI or spinal manipulation are billed alongside.

See how Mira captures M99.25 documentation