2025 ICD-10-CM code M45
(Active) Effective Date: N/A Revision Date: N/A Musculoskeletal - Dorsopathies; Spondylopathies Diseases of the musculoskeletal system and connective tissue (M00-M99) Feed
Ankylosing spondylitis, a chronic inflammatory disease primarily affecting the spine and sacroiliac joints, causing pain, stiffness, and potential spinal fusion.
ICD-10 codes do not utilize modifiers. Modifiers are used with procedural codes (CPT and HCPCS).
Medical necessity for ankylosing spondylitis treatment is established by the presence of clinical symptoms (pain, stiffness, limited mobility), supported by imaging evidence of sacroiliitis and/or spinal inflammation and, where applicable, laboratory results.The severity of symptoms and their impact on daily activities justify the medical necessity of interventions such as NSAIDs, biologics, and physical therapy to alleviate pain, reduce inflammation, and improve functional capacity.
Diagnosis and management of ankylosing spondylitis involves a comprehensive approach including patient history, physical examination, imaging studies (X-rays and MRI), laboratory tests (inflammatory markers, HLA-B27 genetic testing), and treatment planning.The clinical responsibility typically rests with rheumatologists and other specialists who manage musculoskeletal and autoimmune conditions.Primary care physicians often play a role in early detection and referral.
- Diseases of the musculoskeletal system and connective tissue (M00-M99)
- Dorsopathies (M40-M54); Spondylopathies (M45-M49)
In simple words: Ankylosing spondylitis is a type of arthritis that causes inflammation in the spine and joints.It often starts with lower back pain that feels better with movement and worse with rest. Over time, it can cause stiffness and make it hard to move your back and hips.Doctors use X-rays and other tests to diagnose it. Treatment includes medication to reduce pain and inflammation, physical therapy, and exercise.
Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the axial skeleton, characterized by inflammation of the sacroiliac joints (sacroiliitis), entheses (where tendons and ligaments attach to bone), and spine (spondylitis).It leads to pain, stiffness, and, in advanced stages, fusion of vertebrae, resulting in spinal rigidity.Symptoms often begin insidiously with lower back pain, improving with exercise but not rest.Other symptoms include pain in the buttocks, hips, and neck; fatigue; fever; and potential eye, heart, and lung involvement.Diagnosis involves clinical assessment, imaging (X-rays, MRI), and laboratory tests (inflammatory markers, HLA-B27 genetic testing). Treatment focuses on pain management, inflammation reduction (NSAIDs, biologics like TNF inhibitors), and physical therapy to maintain mobility and prevent deformity.In severe cases, surgery may be necessary.
Example 1: A 25-year-old male presents with chronic lower back pain for 6 months, worse at night and improved with exercise. Physical exam reveals limited lumbar spine motion. X-rays show sacroiliitis.Diagnosis: Ankylosing spondylitis. Treatment: NSAIDs, physical therapy., A 30-year-old female with a family history of AS complains of lower back pain, stiffness, and fatigue. MRI reveals sacroiliitis and spinal inflammation.Diagnosis: Ankylosing spondylitis. Treatment: TNF inhibitor, physical therapy., A 40-year-old male with long-standing AS experiences severe spinal stiffness and limited chest expansion.Diagnosis: Ankylosing spondylitis with advanced spinal ankylosis. Treatment: Pain management, consideration of surgical intervention.
Detailed patient history documenting onset, duration, and character of back pain; description of morning stiffness and its response to activity and rest; results of physical examination assessing spine mobility and sacroiliac joint tenderness; imaging reports (X-rays, MRI) showing evidence of sacroiliitis and/or spinal inflammation; laboratory results including inflammatory markers (ESR, CRP) and HLA-B27 genetic testing; documentation of treatment plan including medication prescribed, physical therapy interventions, and any surgical procedures.
** Ankylosing spondylitis is a complex condition, and accurate coding depends on thorough documentation of clinical findings and treatment provided.The information provided here is for educational purposes and should not be construed as definitive medical billing advice. Always consult the latest official ICD-10-CM coding guidelines.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Specialties:Rheumatology, Orthopedics, Internal Medicine
- Place of Service:Office, Hospital (Inpatient and Outpatient), Clinic