M99.67 identifies osseous and subluxation stenosis of the intervertebral foramina affecting the upper extremity region — a biomechanical lesion in which bony overgrowth or vertebral segment subluxation narrows the foraminal opening through which nerve roots exit toward the shoulder, arm, or hand.

Documentation tips

What should appear in the chart to support M99.67.

Source · Editorial brief grounded in 4 cited references ↓

• Specify the spinal level (e.g., C5-C6) contributing to the foraminal stenosis and confirm the neurological referral pattern is to the upper extremity — not just neck pain.
• Record imaging evidence supporting osseous or subluxation-based stenosis: CT or MRI findings of osteophytic foraminal encroachment, facet arthrosis, or segmental malalignment narrow enough to impinge neural structures.
• Distinguish the stenosis mechanism — osseous overgrowth or subluxation — from disc herniation or connective tissue stenosis; the latter belong to M99.7x codes, and conflating them invites an audit query.
• If the clinical presentation includes upper extremity radiculopathy, document it separately so both the causative biomechanical lesion (M99.67) and the radiculopathy code can be reported together where supported.
• Note laterality of upper extremity symptoms (right vs. left arm) in the clinical note even though M99.67 itself does not differentiate laterality — this supports medical necessity and downstream nerve conduction or surgical coding.

Related CPT procedures

Procedure codes commonly billed with M99.67. 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 M99.67 and adjacent codes.

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

• Assigning M99.67 when the foraminal stenosis is documented at the cervical spinal level without confirmed upper extremity neurological distribution — M99.61 (cervical region) may be the correct sibling code in that scenario.
• Using M99.67 for disc-mediated or connective tissue foraminal stenosis; those conditions map to the M99.7x category (e.g., M99.71 for cervical connective tissue and disc stenosis).
• Applying 7th-character extensions (A, D, S) to M99.67 — Chapter 13 M-codes do not use encounter-type extensions; adding one creates an invalid code.
• Defaulting to an unspecified spinal stenosis code (e.g., M48.02) when documentation actually specifies the biomechanical/subluxation mechanism — M99.67 is the more precise and appropriate choice in those cases.

Clinical context

Source · Editorial summary grounded in 4 cited references ↓

Sibling codes

Other billable codes under M99.6 (laterality / anatomic variants).