ICD-10-CM · Spine

M99.75

Stenosis of the intervertebral foramina in the pelvic region caused by connective tissue changes and/or intervertebral disc pathology, resulting in narrowing that can compress exiting nerve roots at the pelvic spinal level.

Verified May 8, 2026 · 5 sources ↓

Status: Billable
Chapter: 13
Related CPT: 10
Region: Spine

Drawn from CDCICD10DataAAPCCMSOpsc

Documentation tips

What should appear in the chart to support M99.75.

Source · Editorial brief grounded in 5 cited references ↓

Document the specific tissue mechanism — connective tissue fibrosis, ligamentous hypertrophy, or disc bulge/herniation — narrowing the pelvic intervertebral foramina; vague 'stenosis' without tissue attribution weakens M99.75 specificity.
Record imaging findings (MRI foraminal narrowing grade, disc protrusion measurements, ligamentum flavum thickness) that confirm the connective tissue or disc etiology rather than pure osseous encroachment.
If radicular symptoms are present (e.g., sciatic distribution, pelvic girdle pain, lower extremity paresthesia), document the nerve root(s) involved as a secondary diagnosis to support medical necessity.
Distinguish the pelvic region from the lumbosacral or lumbar region in documentation; if the foramen involved is at L5–S1 or above, M99.73 (lumbar) may be more accurate than M99.75 (pelvic).
For chiropractic or OMT encounters, document the subluxation or somatic dysfunction level (M99.05 for pelvic region) as the primary diagnosis, with M99.75 supporting the underlying foraminal pathology.

Related CPT procedures

Procedure codes commonly billed with M99.75. Linking the right diagnosis to the right procedure is what establishes medical necessity.

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

72148 $191.72

Non-contrast MRI of the lumbar spine used to evaluate disc pathology, spinal stenosis, nerve root compression, and other structural abnormalities without administration of contrast material.

72158 $318.31

MRI of the lumbar spinal canal and its contents performed first without contrast, then repeated after contrast administration for enhanced visualization.

72195 $227.46

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

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.

97012 $14.36

Mechanical traction applied to one or more areas, usually the cervical or lumbar spine, as a supervised modality during therapy.

98940 $26.72

Chiropractic manipulative treatment of one or two spinal regions in a single visit, used when the chiropractor adjusts a limited area such as the cervical or lumbar spine.

98941 $38.41

Chiropractic manipulative treatment of three or four spinal regions during one encounter, the most common level when neck, mid back, and low back are adjusted together.

98942 $49.77

Chiropractic manipulative treatment of all five spinal regions in one visit: cervical, thoracic, lumbar, sacral, and pelvic.

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.

Common coding pitfalls

The recurring mistakes coders make with M99.75 and adjacent codes.

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

Confusing M99.75 (foraminal stenosis, connective tissue/disc, pelvic) with M99.65 (osseous and subluxation foraminal stenosis, pelvic) — the tissue type driving stenosis must be explicitly documented to justify M99.75 over M99.65.
Substituting M48.06 or M48.07 (structural spinal canal stenosis) when the actual finding is foraminal stenosis; these are anatomically and mechanistically different and will trigger claim scrutiny if unsupported by imaging.
Assigning M99.75 as the sole diagnosis on a chiropractic claim without a primary M99.0x segmental dysfunction code, which most Medicare LCDs require for chiropractic service reimbursement.
Using M99.75 for lumbar-level foraminal stenosis when the provider's notes describe L4–L5 or L5–S1 — those levels are lumbar region (M99.73), not pelvic region.
Omitting secondary radiculopathy or pain codes that substantiate why the foraminal stenosis is clinically significant, which can result in downcoding or denial for services requiring medical necessity documentation.

Clinical context

Source · Editorial summary grounded in 5 cited references ↓

M99.75 captures foraminal stenosis at the pelvic region specifically attributable to connective tissue and disc involvement — distinct from osseous stenosis (M99.65) or subluxation-driven stenosis (M99.25) at the same region. It falls under the M99.7x subcategory of biomechanical lesions, which classifies stenosis by tissue type rather than by structural bony pathology. Use it when the provider documents that disc material or connective tissue (fibrosis, ligamentous hypertrophy, scar tissue) is the primary mechanism narrowing the pelvic intervertebral foramina, with or without associated radicular symptoms into the lower extremity or pelvic girdle.

This code is most frequently applied in chiropractic, osteopathic, physiatry, and spine-focused orthopedic settings. It may accompany sacral or lumbosacral transition-level pathology when the foramen affected is anatomically in the pelvic region. If the stenosis involves the lumbar foramina rather than the pelvic foramina, use M99.73 instead — laterality is not captured in the M99.7x subcategory, so the region descriptor carries the full specificity burden.

Do not use M99.75 interchangeably with M48.06 (spinal stenosis, lumbar region) or M48.07 (spinal stenosis, lumbosacral region). Those codes reflect structural spinal canal stenosis, while M99.75 is specifically a biomechanical classification targeting foraminal narrowing from connective tissue and disc sources. Payer LCDs — particularly Medicare for chiropractic — often require an M99.0x segmental dysfunction code as primary with M99.75 as a supporting secondary diagnosis.

Sibling codes

Other billable codes under M99.7 (laterality / anatomic variants).

M99.78

Conn tiss and disc stenosis of intvrt foramina of rib cage

M99.72

Conn tiss and disc stenos of intvrt foramin of thor region

M99.70

Conn tiss and disc stenosis of intvrt foramin of head region

M99.77

Conn tiss and disc stenosis of intvrt foramina of up extrem

M99.74

Conn tiss and disc stenos of intvrt foramin of sacral region

M99.76

Conn tiss and disc stenosis of intvrt foramina of low extrm

M99.79

Conn tiss & disc stenos of intvrt foramin of abd and oth rgn

M99.71

Conn tiss and disc stenosis of intvrt foramin of cerv region

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What distinguishes M99.75 from M99.73?

Region. M99.73 targets connective tissue and disc stenosis of the intervertebral foramina in the lumbar region; M99.75 targets the same pathology at the pelvic region. If the affected foramen is at L1–L5, use M99.73. If it is at the sacral/pelvic level, use M99.75.

02Can M99.75 be used as a primary diagnosis on a chiropractic claim?

Generally no for Medicare. Most Medicare LCDs require an M99.0x segmental and somatic dysfunction code (e.g., M99.05 for pelvic region) as the primary diagnosis on chiropractic claims, with M99.75 listed as a secondary supporting code. Verify the applicable LCD for your MAC.

03Does M99.75 require laterality?

No. The M99.7x subcategory codes by region, not by side. There is no left/right distinction within M99.75 — the pelvic region designation is the full extent of specificity available in this subcategory.

04Is M99.75 appropriate when both osseous and connective tissue/disc factors are contributing to foraminal stenosis?

If osseous and subluxation components are also present, M99.65 (osseous and subluxation stenosis of intervertebral foramina, pelvic region) may be a more accurate code, or both M99.65 and M99.75 can be assigned if documentation supports distinct contributions. Query the provider if the dominant mechanism is unclear.

05What imaging documentation best supports M99.75?

MRI is the strongest support, particularly sequences showing foraminal narrowing from disc protrusion, annular bulge, ligamentum flavum hypertrophy, or scar tissue in the pelvic region. Document the specific findings (e.g., 'moderate foraminal stenosis at S1 from posterior disc protrusion and ligamentous thickening') rather than a generic 'stenosis' note.

06How does M99.75 differ from spinal stenosis codes like M48.06?

M48.06 captures structural narrowing of the spinal canal (central stenosis) in the lumbar region. M99.75 is specifically foraminal stenosis — narrowing of the nerve exit portal — caused by connective tissue and disc pathology in the pelvic region. They describe different anatomical compartments and should not be used interchangeably.

07Is M99.75 valid for FY2026 billing?

Yes. M99.75 is a valid, billable ICD-10-CM code effective October 1, 2025 under the FY2026 code set with no reported changes from the prior year.

Sources & references

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

01CDC ICD-10-CM Tabular List 2026
02
icd10data.com
https://www.icd10data.com/ICD10CM/Codes/M00-M99/M99-M99/M99-/M99.75
03
aapc.com
https://www.aapc.com/codes/icd-10-codes/M99.75
04
cms.gov
https://www.cms.gov/medicare/coding/icd10/downloads/icd10clinicalconceptsorthopedics1.pdf
05
opsc.org
https://www.opsc.org/page/ICD-10

Mira Scribe

Mira AI Scribe captures the tissue mechanism (connective tissue fibrosis, ligamentous thickening, disc bulge), the precise anatomical region (pelvic vs. lumbar), relevant MRI or CT foraminal grading, and any documented radicular symptoms — preventing the most common M99.75 audit flag: a stenosis code with no imaging-supported tissue attribution or a region mismatch that sends the claim to M99.73.

See how Mira captures M99.75 documentation