2025 ICD-10-CM code M99
(Active) Effective Date: N/A Diseases of the musculoskeletal system and connective tissue - Biomechanical lesions, not elsewhere classified 13 Feed
Biomechanical lesion not otherwise specified. This code is used for biomechanical lesions that are not described by any other code.
Medical necessity for M99 is established when the patient's symptoms and functional limitations are directly related to the biomechanical lesion. Documentation must support the need for the chosen treatment plan, such as pain management, physical therapy, or other interventions.
Providers diagnose biomechanical lesions based on patient history, physical examination, and imaging studies (X-rays, MRI, CT). Treatment options include pain medication, spinal manipulation, physical therapy, and massage therapy.
In simple words: A biomechanical lesion is an area of damaged tissue, often in the spine, that causes pain, stiffness, and limited movement. It's usually caused by injury but can also be due to disease. This code is used when the specific type of biomechanical lesion isn't covered by another code.
Biomechanical lesions, not elsewhere classified, are areas of tissue that have suffered damage through injury or disease which may result in pain, stiffness, muscle spasm, a restriction of movement, and fatigue. This code represents a biomechanical lesion that isn't described by any other code in the ICD-10-CM classification system.
Example 1: A patient presents with chronic lower back pain and limited range of motion after a fall. Imaging studies reveal soft tissue damage consistent with a biomechanical lesion, but the specific type of lesion is not clearly defined. M99 is used as the diagnosis code., A patient experiences neck pain and stiffness following a car accident. Physical examination reveals muscle spasm and restricted movement. X-rays rule out fractures or dislocations. Since the specific lesion is not described by other codes, M99 is appropriate., A patient reports ongoing shoulder pain and reduced mobility after repetitive lifting at work. Diagnostic tests show no other specific pathology but indicate a biomechanical lesion. Due to the lack of a more specific code, M99 is used.
Documentation should include details of the patient's symptoms, history of injury or disease, physical examination findings, and results of imaging studies. It is important to rule out other specific diagnoses before using M99.
- Specialties:Orthopedics, physiatry, pain management, chiropractic, physical therapy
- Place of Service:Office, Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital,Emergency Room - Hospital,Ambulatory Surgical Center, Independent Clinic, Federally Qualified Health Center