M49.85 — Spondylopathy in diseases classified elsewhere, thoracolumbar region

Billable

Is M49.85 billable?

Yes — M49.85 is billable for FY2027. M49.85 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. M49.85 may be submitted for encounters from October 1, 2026 through September 30, 2027.

M49.85 at a glance

Code	M49.85
Description	Spondylopathy in diseases classified elsewhere, thoracolumbar region
Billable	Yes
Code set	ICD-10-CM FY2027
Valid for encounters	October 1, 2026 – September 30, 2027

What Medicare edits apply to M49.85?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name M49.85 directly.

Manifestation code — never sequenced first — MCE edit 6

This code describes a manifestation of an underlying disease. The underlying condition must be sequenced before it, so it can never be the principal or first-listed diagnosis.

Which MS-DRGs does M49.85 group to?

M49.85 sits in MDC 08 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.

551Medical Back Problems with MCCmedical
552Medical Back Problems without MCCmedical

How is M49.85 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to M49.85. They show the wording a clinician may have documented, which often differs from the Tabular description.

Scoliosis › rachitic › thoracolumbar region (acquired) (postural)
Spondylitis › in › brucellosis › thoracolumbar region (chronic)

Excludes1 — never code together — inherited from M49

The conditions below can never be reported together with M49.85 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

curvature of spine in tuberculosis [Pott's] (A18.01)
enteropathic arthropathies (M07.-)
gonococcal spondylitis (A54.41)
neuropathic [tabes dorsalis] spondylitis (A52.11)
neuropathic spondylopathy in syringomyelia (G95.0)
neuropathic spondylopathy in tabes dorsalis (A52.11)
nonsyphilitic neuropathic spondylopathy NEC (G98.0)
spondylitis in syphilis (acquired) (A52.77)
tuberculous spondylitis (A18.01)
typhoid fever spondylitis (A01.05)

Code first — inherited from M49

The underlying condition below must be sequenced before M49.85. M49.85 describes a manifestation and cannot be the principal or first-listed diagnosis.

underlying disease, such as:
brucellosis (A23.-)
Charcot-Marie-Tooth disease (G60.0)
enterobacterial infections (A01-A04)
osteitis fibrosa cystica (E21.0)

Excludes2 — not included here — inherited from Chapter 13

The conditions below are not part of M49.85, but a patient may have both at the same time. When documentation supports it, M49.85 and the excluded code may both be reported.

arthropathic psoriasis (L40.5-)
certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
compartment syndrome (traumatic) (T79.A-)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

How long has M49.85 existed?

M49.85 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.

Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.