ICD-10-CM · Other

M99.76

Stenosis of the intervertebral foramina of the lower extremity caused by connective tissue and/or disc encroachment, classified as a biomechanical lesion under the M99 category.

Verified May 8, 2026 · 5 sources ↓

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

Drawn from CDCICD10DataCMSPainphysicianjournalOpsc

Documentation tips

What should appear in the chart to support M99.76.

Source · Editorial brief grounded in 5 cited references ↓

Specify that the foraminal stenosis involves connective tissue and disc components — both must be documented to support M99.76 over M99.66 (osseous/subluxation only).
Document which lower-extremity nerve distribution is affected (e.g., L4, L5, S1 dermatome) to support medical necessity for imaging and treatment.
Record imaging findings (MRI or CT) confirming foraminal narrowing, including the level(s) involved and characterization of the stenotic material.
If treating with OMT, document the biomechanical findings that led to the M99.76 diagnosis, as payers may require functional or structural rationale for this category.
Note any conservative care history (physical therapy, injections, chiropractic) if the patient is being considered for surgical intervention, establishing medical necessity.

Related CPT procedures

Procedure codes commonly billed with M99.76. Linking the right diagnosis to the right procedure is what establishes medical necessity.

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

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.

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.

72100 $40.42

Radiologic examination of the lumbosacral spine capturing two or three views, used to evaluate the lumbar vertebrae and sacrum for injury, degeneration, or structural abnormality.

72110 $53.44

Radiologic examination of the lumbar spine (lumbosacral) with a minimum of four views, including oblique and/or bending views.

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.

99215 $192.39

Highest-level office or outpatient E/M visit for an established patient, qualifying via high-complexity medical decision making or 40–54 minutes of total provider time on the date of service.

97530 View procedure details

98925 View procedure details

98926 View procedure details

98927 View procedure details

Common coding pitfalls

The recurring mistakes coders make with M99.76 and adjacent codes.

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

Assigning M99.76 when the record documents only degenerative disc disease or spondylosis without a biomechanical lesion framing — use M48.0x or M54.1x instead.
Confusing M99.76 (connective tissue AND disc, foraminal) with M99.66 (osseous/subluxation, foraminal) or M99.56 (disc only, neural canal) — the sub-type distinction is based on the documented stenotic mechanism and anatomical location (foramina vs. canal).
Failing to distinguish foraminal stenosis (M99.7x) from neural canal stenosis (M99.4x–M99.5x) — these are anatomically distinct and coded separately.
Using M99.76 as a primary diagnosis when the visit's chief complaint and clinical focus is a more specific condition already captured by another M-code, resulting in redundant or conflicting primary diagnosis coding.

Clinical context

Source · Editorial summary grounded in 5 cited references ↓

M99.76 applies when connective tissue changes or disc material narrow the intervertebral foramina at a level whose neural pathways serve the lower extremity, producing radicular or referred symptoms in the leg — and the clinician attributes the stenosis to a biomechanical or osteopathic mechanism rather than a primary structural spine diagnosis such as M48.0x (spinal stenosis). This code sits within the M99.7x subcategory, which distinguishes combined connective tissue and disc foraminal stenosis from purely osseous/subluxation stenosis (M99.6x), purely connective tissue neural canal stenosis (M99.4x), or purely disc-based neural canal stenosis (M99.5x). Choose M99.76 only when the physician's documentation specifically identifies both connective tissue and disc components as contributors to foraminal narrowing affecting lower-extremity nerve distribution.

In orthopedic and osteopathic practice, M99.76 is most likely to appear as a secondary diagnosis alongside primary procedure or condition codes, or as a primary diagnosis when the visit is explicitly focused on the biomechanical foraminal stenosis. It pairs commonly with osteopathic manipulative treatment (OMT) CPT codes and with diagnostic imaging CPT codes used to evaluate foraminal patency. If the foraminal stenosis is documented as purely degenerative or structural (e.g., spondylotic), consider whether M48.0x or a more specific lumbar radiculopathy code (M54.1x) better captures the documented pathology.

The M99 category is reserved for biomechanical lesions not classified elsewhere. Using M99.76 when the record actually documents a primary structural disc herniation or spondylosis without a biomechanical framing may attract a payer query. Confirm the treating provider's diagnostic language aligns with the biomechanical lesion framework before assigning this code.

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

M99.79

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

M99.73

Conn tiss and disc stenos of intvrt foramin of lumbar region

Frequently asked questions

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

01When should I use M99.76 instead of M48.06 (spinal stenosis, lumbar region)?

Use M99.76 when the provider's documentation frames the foraminal stenosis as a biomechanical lesion — typically in osteopathic or chiropractic contexts — and identifies both connective tissue and disc as the stenotic agents. Use M48.06 when the diagnosis is a structural degenerative spinal stenosis documented without a biomechanical lesion framing.

02Does M99.76 require laterality?

No. The M99.7x subcategory does not include a laterality character; M99.76 identifies the lower extremity as the region without distinguishing right from left. Document affected side in the clinical note for completeness, but the code itself does not split by laterality.

03What is the difference between M99.76 and M99.66?

M99.66 is osseous and subluxation stenosis of the intervertebral foramina of the lower extremity; M99.76 is connective tissue and disc stenosis of the same location. The distinction lies in the documented mechanism: bony/subluxation changes versus combined connective tissue and disc changes.

04Can M99.76 be billed with OMT CPT codes?

Yes. M99.76 is an accepted supporting diagnosis for osteopathic manipulative treatment CPT codes (98925–98929). Ensure the documented biomechanical findings and the OMT region treated are consistent with the lower-extremity foraminal stenosis diagnosis.

05Is M99.76 appropriate as a primary diagnosis or only secondary?

M99.76 can be used as a primary diagnosis when the encounter's documented reason for visit is the foraminal stenosis itself. It commonly appears as a secondary diagnosis when a more specific condition code is primary, or when multiple biomechanical lesions are documented across regions.

06Does M99.76 apply to both lumbar and sacral levels if the symptoms affect the lower extremity?

The code designates the lower extremity as the affected region in the M99 site classification system — it reflects where the neural distribution goes, not strictly the spinal level. Code the level-specific finding with supporting documentation; if multiple spinal levels contribute, additional codes may be appropriate.

Sources & references

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

Mira AI Scribe

Mira AI Scribe captures the provider's characterization of foraminal stenosis type (connective tissue, disc, or combined), the affected spinal level(s), the lower-extremity nerve distribution involved, imaging findings confirming foraminal narrowing, and any biomechanical examination findings. This prevents downcoding to a less specific M99.7x sibling or miscoding to a structural stenosis code, and avoids audit flags when OMT or manual therapy CPT codes are billed alongside.

See how Mira captures M99.76 documentation