M47 vs M54.1
M47 and M54.1 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on M54.1
radiculopathy with spondylosis (M47.2-)
M47
Spondylosis
Not billable
- Chapter 13
- Diseases of the musculoskeletal system and connective tissue
- Section
- M45-M49
Use when the record says
- arthrosis or osteoarthritis of spine
- degeneration of facet joints
M54.1
Radiculopathy
Not billable
- Chapter 13
- Diseases of the musculoskeletal system and connective tissue
- Section
- M50-M54
Use when the record says
- Brachial neuritis or radiculitis NOS
- Lumbar neuritis or radiculitis NOS
- Lumbosacral neuritis or radiculitis NOS
- Thoracic neuritis or radiculitis NOS
- Radiculitis NOS
Indexed under
- Radiculopathy › leg
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027