Crystal's Coder Hub🧬 ICD-10 CM M47.812 — Spondylosis Without Myelopathy or Radiculopathy, Cervical Region
Billable Code Confirmed
ICD-10-CM M47.812 is a valid, billable 7-character ICD-10-CM code for FY2026.[¹][²] The first character (M) designates the Diseases of the Musculoskeletal System chapter; characters 2-3 (47) identify the M47 category (Spondylosis); characters 4-5 (.81) specify the subcategory of spondylosis without myelopathy or radiculopathy; and the seventh character (2) designates the cervical region as the anatomic site of involvement. No additional characters or extensions are required — M47.812 is complete and terminal as written.
Non-Billable Parent Codes — Never Submit These
- ❌
M47— 3-character header — no region or complication specified- ❌
M47.81— 5-character subcategory header — region not specified; not valid for submissionAlways submit M47.812 (all 7 characters) when cervical spondylosis is documented without myelopathy and without radiculopathy.
Clinical Context: The Absence of Neurological Involvement Is the Defining Feature
ICD-10-CM M47.812 is the correct code only when degenerative cervical spine changes are present without clinical evidence of spinal cord compression (myelopathy) or nerve root compression (radiculopathy). The moment the provider documents upper extremity radicular symptoms, dermatomal pain, weakness, hyperreflexia, or myelopathic signs, the code must shift to M47.22 (radiculopathy) or M47.12 (myelopathy) respectively. Defaulting to M47.812 for all cervical spondylosis encounters — regardless of neurological findings — is a documented audit risk and a compliance violation.[³]
Code Classification
ICD-10-CM Diagnosis Code — wRVU, assistant payable status, and global period fields are not applicable to diagnosis codes. For procedure coding associated with evaluation and management of cervical spondylosis, refer to the CPT Procedural Crosswalk and ICD-10-PCS Crosswalk sections below.
🔍 Code Description
ICD-10-CM M47.812 classifies spondylosis without myelopathy or radiculopathy of the cervical region — a degenerative condition of the cervical spine characterized by progressive arthrosis of the intervertebral discs, facet joints, and vertebral endplates, with osteophyte formation, disc space narrowing, and ligamentous hypertrophy, in the absence of documented neurological compromise.[²][³]
The cervical region (C1-C7) is the second most commonly affected spinal segment after the lumbar spine. Degenerative changes accumulate over decades as the nucleus pulposus desiccates, disc height decreases, facet joint cartilage erodes, and osteophytes develop at the uncovertebral joints (joints of Luschka) and vertebral end plates.[³] These changes are captured under M47 with the inclusion terms arthrosis or osteoarthritis of spine and degeneration of facet joints, both of which are listed as includes terms directly under the M47 category header.[¹] The critical distinction for code selection is the clinical determination by the provider that no myelopathy (cord compression signs) and no radiculopathy (nerve root compression signs) are present — imaging findings of canal narrowing or foraminal stenosis alone are insufficient to upgrade this code without correlating neurological documentation.[³]
🌳 Code Tree / Hierarchy
M47 Spondylosis ❌ Non-billable
│ [Includes: arthrosis or osteoarthritis of spine; degeneration of facet joints]
│
├── M47.0x Anterior spinal and vertebral artery compression syndromes ❌ Non-billable
│ ├── M47.011 Anterior spinal artery compression syndrome, occipito-atlanto-axial region ✅ Billable
│ ├── M47.012 Anterior spinal artery compression syndrome, cervical region ✅ Billable
│ └── M47.019 Anterior spinal artery compression syndrome, site unspecified ✅ Billable
│
├── M47.1x Other spondylosis with myelopathy ❌ Non-billable
│ ├── M47.11 Other spondylosis with myelopathy, occipito-atlanto-axial region ✅ Billable
│ ├── M47.12 Other spondylosis with myelopathy, cervical region ✅ Billable
│ └── M47.13 Other spondylosis with myelopathy, cervicothoracic region ✅ Billable
│
├── M47.2x Other spondylosis with radiculopathy ❌ Non-billable
│ ├── M47.21 Other spondylosis with radiculopathy, occipito-atlanto-axial region ✅ Billable
│ ├── M47.22 Other spondylosis with radiculopathy, cervical region ✅ Billable
│ └── M47.23 Other spondylosis with radiculopathy, cervicothoracic region ✅ Billable
│
├── M47.81 Spondylosis without myelopathy or radiculopathy ❌ Non-billable (subcategory header)
│ ├── M47.811 Spondylosis w/o myelopathy or radiculopathy, occipito-atlanto-axial region ✅ Billable
│ ├── M47.812 Spondylosis w/o myelopathy or radiculopathy, cervical region ◀ THIS CODE ✅ Billable
│ ├── M47.813 Spondylosis w/o myelopathy or radiculopathy, cervicothoracic region ✅ Billable
│ ├── M47.814 Spondylosis w/o myelopathy or radiculopathy, thoracic region ✅ Billable
│ ├── M47.815 Spondylosis w/o myelopathy or radiculopathy, thoracolumbar region ✅ Billable
│ ├── M47.816 Spondylosis w/o myelopathy or radiculopathy, lumbar region ✅ Billable
│ ├── M47.817 Spondylosis w/o myelopathy or radiculopathy, lumbosacral region ✅ Billable
│ └── M47.818 Spondylosis w/o myelopathy or radiculopathy, sacral/sacrococcygeal region ✅ Billable
│
├── M47.89 Other spondylosis ❌ Non-billable (subcategory header)
│ ├── M47.891 Other spondylosis, occipito-atlanto-axial region ✅ Billable
│ ├── M47.892 Other spondylosis, cervical region ✅ Billable
│ └── M47.893 Other spondylosis, cervicothoracic region ✅ Billable
│
└── M47.9 Spondylosis, unspecified ✅ Billable
Neurological Involvement Changes the Code Entirely
If on re-evaluation a patient previously coded as M47.812 develops new upper extremity radiculopathy or signs of myelopathy (gait disturbance, hand clumsiness, hyperreflexia), the code must be updated to M47.22 (radiculopathy) or M47.12 (myelopathy) respectively. These are distinct, more specific codes — not addons to M47.812. Never stack M47.812 with M47.12 or M47.22 for the same spinal region.
✅ Includes
The following clinical terms and scenarios map to M47.812 when documented:
- Cervical spondylosis NOS without neurological deficit
- Arthrosis of cervical spine (facet joint degeneration)
- Osteoarthritis of the cervical vertebral joints
- Degeneration of cervical facet joints (documented without myelopathy or radiculopathy)
- Cervical osteophyte formation on imaging with neck pain but no radicular or myelopathic symptoms
- Degenerative cervical disc and facet changes found incidentally or as primary complaint without neurological involvement
- Cervical spondylosis documented as “uncomplicated” or “without neurological findings”
❌ Excludes
Excludes 1 — Cannot Be Coded Simultaneously with M47.812 (Same Region)
| Code | Description | Note |
|---|---|---|
| M47.12 | Other spondylosis with myelopathy, cervical region | Mutually exclusive — if myelopathy is documented at the cervical level, use M47.12 only; M47.812 and M47.12 cannot coexist for the same cervical region |
| M47.22 | Other spondylosis with radiculopathy, cervical region | Mutually exclusive — if cervical radiculopathy is documented, use M47.22 only; M47.812 and M47.22 cannot coexist for the cervical region |
Excludes 1 Violation Risk
The most common and highest-risk coding error with M47.812 is assigning it when the provider has actually documented radicular symptoms (arm pain, paresthesias, dermatomal sensory loss) or myelopathic signs (gait disturbance, Lhermitte sign, hyperreflexia, positive Hoffman’s sign). Using M47.812 in this clinical scenario understates the severity of the condition, misrepresents the diagnosis, and may constitute upcoding or downcoding depending on context. Always review the provider’s neurological assessment — not just the imaging report — before finalizing code selection.
Excludes 2 — May Be Coded in Addition if Separately Present
| Code | Description | Note |
|---|---|---|
| M50.12 | Cervical disc degeneration, mid-cervical region | May be coded alongside M47.812 if disc pathology is separately documented as a distinct condition at a specific disc level |
| M54.2 | Cervicalgia | May be coded additionally when neck pain is documented as a presenting complaint separate from the spondylosis itself |
📋 Clinical Overview
Spondylosis Spectrum — Cervical Region Code Selection by Neurological Status
Accurate cervical spondylosis coding depends entirely on the neurological examination findings documented by the provider. The table below maps clinical documentation language to the correct code.
| Feature | M47.812 — Without Neuro Involvement | M47.22 — With Radiculopathy | M47.12 — With Myelopathy |
|---|---|---|---|
| Spinal Pathology | Disc degeneration, facet arthrosis, osteophytes | Foraminal stenosis with nerve root compression | Central canal stenosis with cord compression |
| Neurological Exam | Normal or non-specific neck pain only | Dermatomal arm pain, paresthesias, reduced reflex | Hyperreflexia, Hoffman’s sign, gait changes, hand clumsiness |
| Key Provider Language | ”Cervical spondylosis,” “cervical DJD,” “no neuro deficits" | "Cervical radiculopathy,” “nerve root compression,” “arm pain radiating C5/C6/C7 distribution" | "Cervical myelopathy,” “spinal cord compression,” “myelopathic changes on MRI” |
| Imaging Correlation | Osteophytes, disc space narrowing — no cord signal change | Foraminal narrowing correlating with symptoms | T2 cord signal change, cord compression |
| Typical Management | PT, NSAIDs, cervical traction, lifestyle modification | Selective nerve root block, PT, surgical consult if refractory | Urgent surgical decompression evaluation |
| DRG Impact (Inpatient) | DRG 551-553 (Medical Back) | DRG 551-553 or surgical DRG if operated | DRG 551-553 or high-weight surgical DRG |
CDI Query Trigger — Imaging Findings vs. Clinical Diagnosis
Radiologists frequently describe “cervical canal stenosis,” “foraminal narrowing,” or “cord flattening” on MRI reports. These imaging descriptors alone do not justify upgrading from M47.812 to M47.12 or M47.22. A CDI query should be sent whenever imaging findings suggest cord or nerve root compression but the provider’s clinical documentation does not explicitly state myelopathy or radiculopathy. The physician’s clinical correlation — not the radiology report — drives the ICD-10-CM code selection.
Manifestations & Symptom Burden
Commonly documented symptoms and associated conditions in cervical spondylosis without neurological compromise:
- Cervicalgia (neck pain): M54.2 — code separately when documented as a primary complaint
- Neck stiffness / reduced ROM: Captured clinically; document in support of conservative management medical necessity
- Occipital headache: M54.81 — Occipital neuralgia, if separately documented
- Muscle spasm, cervical: M62.838 — Muscle spasm, other site, if separately documented by provider
- Intervertebral disc degeneration: M50.12 or M50.122 — if discrete disc pathology is separately documented at a specific level alongside the facet/arthrosis findings
Coding Manifestations
Code the documented symptoms and comorbidities separately to fully represent clinical complexity and support medical necessity for imaging, injections, and physical therapy. Examples:
- M54.2 — Cervicalgia (neck pain as presenting complaint)
- M50.12 — Cervical disc degeneration, mid-cervical region (if disc degeneration is specifically documented at C3-C7)
- M47.22 — Spondylosis with radiculopathy, cervical region (if radiculopathy develops — replaces M47.812, not an add-on)
💰 HCC Risk Adjustment (CMS-HCC v28)
| Field | Detail |
|---|---|
| CMS-HCC Model Version | v28 (2024-2025 Implementation) |
| HCC Assignment | ❌ Not HCC-Mapped |
| HCC Category | N/A |
| RAF Coefficient | N/A |
M47.812 does not map to an HCC under CMS-HCC v28 and does not contribute to a patient’s RAF score.[⁴]
No Annual Capture Requirement for Risk Adjustment
M47.812 carries no HCC weight and no annual RAF capture requirement. However, if the condition progresses to myelopathy (M47.12) and the patient requires chronic care management, reassess at each encounter whether neurological documentation has changed. Comorbidities commonly associated with cervical spondylosis — such as diabetes (HCC 17/18), obesity (HCC 48), or osteoporosis — may themselves carry HCC weight and should be coded and recaptured annually.
🏥 MS-DRG Assignment
MDC 08 — Diseases and Disorders of the Musculoskeletal System and Connective Tissue
| DRG | Title | Est. Relative Weight* |
|---|---|---|
| DRG 551 | Medical Back Problems with MCC | ~1.85 - 2.10 |
| DRG 552 | Medical Back Problems with CC | ~1.00 - 1.20 |
| DRG 553 | Medical Back Problems without CC/MCC | ~0.65 - 0.80 |
Approximate. Verify against IPPS FY2026 Final Rule tables.
Sequencing, Medical Necessity, and Surgical DRG Consideration
When M47.812 sequences as the principal inpatient diagnosis, it groups to the Medical Back Problems DRG 551-553 tier. Since cervical spondylosis without neurological involvement is generally managed outpatient, inpatient admissions may face medical necessity scrutiny — ensure documentation supports the need for inpatient-level care (failed outpatient management, pain crisis, need for IV therapy, or surgical planning). If the patient undergoes cervical surgery during the same admission (ACDF, posterior cervical fusion), the case may re-group to a significantly higher-weighted surgical DRG (e.g., DRG 473-474 — Cervical Spinal Fusion), which would substantially affect reimbursement.[⁵]
🔗 Related ICD-10-CM Codes
Spondylosis by Neurological Complication — Cervical Region
| Code | Description |
|---|---|
| M47.812 | Spondylosis without myelopathy or radiculopathy, cervical region ← This Code |
| M47.22 | Other spondylosis with radiculopathy, cervical region |
| M47.12 | Other spondylosis with myelopathy, cervical region |
| M47.892 | Other spondylosis, cervical region |
Spondylosis Without Myelopathy or Radiculopathy — by Spinal Region
| Code | Description |
|---|---|
| M47.811 | Spondylosis w/o myelopathy or radiculopathy, occipito-atlanto-axial region |
| M47.812 | Spondylosis w/o myelopathy or radiculopathy, cervical region ← This Code |
| M47.813 | Spondylosis w/o myelopathy or radiculopathy, cervicothoracic region |
| M47.816 | Spondylosis w/o myelopathy or radiculopathy, lumbar region |
Commonly Associated or Distinguished Codes
| Code | Description |
|---|---|
| M54.2 | Cervicalgia — may be coded additionally |
| M50.12 | Cervical disc degeneration, mid-cervical region — may be coded additionally |
| M50.122 | Cervical disc degeneration, mid-cervical region, C4-C5 |
| M50.222 | Cervical disc displacement, mid-cervical region, C4-C5 |
🛠️ Commonly Associated CPT Codes (Orthopedics / Neurosurgery / Pain Management)
Outpatient, Profee, and Inpatient Surgical Context
CPT codes associated with M47.812 span office E/M, diagnostic imaging, interventional pain procedures, and surgical spine procedures. In outpatient settings, imaging interpretation and cervical injection procedures are most common. Inpatient surgical scenarios typically involve ACDF or posterior cervical decompression with or without fusion.
| CPT Code | Description | Profee Coding Notes |
|---|---|---|
| 99214 | Established patient E/M, moderate complexity (outpatient) | Appropriate for follow-up management of cervical spondylosis with new symptom assessment or medication adjustment; Modifier -25 required if same-day procedure |
| 72141 | MRI cervical spine without contrast | Append Modifier -26 for physician interpretation only; standard initial imaging for cervical spondylosis workup |
| 72142 | MRI cervical spine with contrast | Append Modifier -26; used when neoplasm or infection is in differential or post-surgical evaluation |
| 72148 | MRI lumbar spine without contrast | Append Modifier -26; often ordered concurrently when multilevel degenerative disease is present |
| 64490 | Injection, diagnostic or therapeutic, paravertebral facet joint, cervical, first level | Primary injection CPT for cervical facet syndrome associated with spondylosis; Modifier -25 on same-day E/M |
| 64491 | Injection, diagnostic or therapeutic, paravertebral facet joint, cervical, second level | Add-on code to 64490; do not bill without 64490 |
| 22551 | ACDF, single level | Surgical CPT for cervical spondylosis requiring anterior cervical discectomy and fusion; global period 090 days |
| 22552 | ACDF, additional level | Add-on to 22551; do not bill without 22551 |
NCCI Bundling Considerations
- 64490 and 64491 (cervical facet injections): 64491 is an add-on code and cannot be billed alone — it must accompany 64490. A maximum of three levels may be billed per side per session (64490 + 64491 + 64492); verify payer-specific limits.
- E/M (99213-99215) billed on the same date as 64490: append Modifier -25 to the E/M to confirm the evaluation is separately identifiable from the pre/post-injection assessment included in the procedure.
- 22551 and 22552 (ACDF): 22552 is an add-on code and cannot be billed without 22551 as the primary procedure code. Multiple-level ACDF billing must match operative report documentation of each level addressed.
🔬 ICD-10-PCS Crosswalk (Inpatient Procedures)
When M47.812 is an inpatient diagnosis and surgical intervention is performed, these PCS codes represent the most common associated inpatient procedures.
| PCS Section | Body System | Root Operation | Clinical Application |
|---|---|---|---|
| 0 (Medical & Surgical) | R (Upper Joints) | G (Fusion) | Anterior cervical discectomy and fusion (ACDF), single level, anterior column, anterior approach; example PCS: 0RG20A0 |
| 0 (Medical & Surgical) | R (Upper Joints) | G (Fusion) | Posterior cervical fusion, single level, posterior column, posterior approach; example PCS: 0RG20071 |
| 0 (Medical & Surgical) | R (Upper Joints) | N (Release) | Cervical foraminotomy/laminoplasty for decompression without fusion; example PCS: 0RN20ZZ |
| 0 (Medical & Surgical) | R (Upper Joints) | B (Excision) | Partial excision of cervical vertebral joint (Cervical osteophyte/disc resection component); example PCS: 0RB20ZZ |
💊 Coding Scenarios and Examples
Scenario 1 — Outpatient Orthopedics: Cervical Spondylosis Managed Conservatively
Clinical Vignette: A 62-year-old male presents to orthopedic clinic for a 6-month history of progressively worsening neck pain and stiffness, worse with prolonged computer use. He denies arm pain, numbness, tingling, or weakness. Neurological exam documents 5/5 grip strength bilaterally, symmetric deep tendon reflexes, no Hoffman’s sign, and no Lhermitte’s. Cervical ROM is limited in extension. MRI cervical spine ordered at prior visit shows multilevel disc space narrowing, uncovertebral osteophytes at C4-C5 and C5-C6, and mild foraminal narrowing bilaterally — radiology states “no cord signal abnormality.” Provider documents: “Cervical spondylosis without myelopathy or radiculopathy. Continue conservative management — PT referral and NSAIDs.”
CPT / HCPCS (Profee):
- 99214 — Established patient E/M, moderate complexity (new imaging results reviewed; treatment plan adjusted; Modifier -25 not required — no same-day procedure)
ICD-10-CM Primary Diagnosis:
- M47.812 — Spondylosis without myelopathy or radiculopathy, cervical region (provider explicitly documents absence of myelopathy and radiculopathy)
ICD-10-CM Secondary Diagnoses:
- M54.2 — Cervicalgia (neck pain as separately documented presenting complaint)
Scenario 2 — Inpatient: Cervical Spondylosis with Elective ACDF
Clinical Vignette: A 57-year-old female with a 2-year history of cervical spondylosis and refractory neck and bilateral shoulder pain presents for elective anterior cervical discectomy and fusion at C5-C6 and C6-C7 following failure of PT, cervical facet injections, and oral analgesics. Pre-operative neurological exam confirms no myelopathic or radiculopathic findings. Surgeon documents: “Cervical spondylosis C5-C6 and C6-C7, without myelopathy or radiculopathy. Proceeding with ACDF C5-C7 for severe mechanical neck pain and functional limitation.”
Principal Diagnosis:
- M47.812 — Spondylosis without myelopathy or radiculopathy, cervical region (confirmed reason for surgical admission)
Secondary Diagnoses:
- M54.2 — Cervicalgia (documented chronic neck pain)
- Z96.641 — Presence of right artificial shoulder joint (if applicable — example secondary comorbidity)
MS-DRG Assignment: With ACDF procedure (ICD-10-PCS fusion codes), this case re-groups from Medical Back DRG 551-553 to a Cervical Spinal Fusion DRG (DRG 473 or 474 — Cervical Spinal Fusion with or without CC/MCC), which carries significantly higher relative weight than medical DRGs. Confirm procedure codes match operative documentation of levels fused and approach used.[⁵]
Scenario 3 — CDI Query: Imaging Shows Foraminal Narrowing, Clinical Documentation Is Vague
Clinical Vignette: A 66-year-old male is seen in spine clinic. MRI cervical spine report describes: “Severe foraminal stenosis at C5-C6 and C6-C7 bilaterally with likely nerve root compression.” The attending’s assessment reads: “Cervical DJD — refer to PT.” No neurological examination findings are documented. The coder must determine whether to assign M47.812 (no neurological involvement) or M47.22 (radiculopathy). The imaging report alone uses “likely nerve root compression” — but this is a radiological impression, not a clinical diagnosis.
Action / Outcome: A CDI query is required. The coder cannot use the radiologist’s “likely nerve root compression” language to assign M47.22 because this is a probable finding in a radiological report, not a confirmed clinical diagnosis by the treating provider. The query should ask the attending to clarify whether cervical radiculopathy is present based on the clinical examination.
Query Response: Provider updates documentation: “Cervical spondylosis with bilateral C6 radiculopathy confirmed on clinical exam — patient reports bilateral arm numbness in C6 distribution with reduced biceps reflex bilaterally. Upgrading diagnosis to cervical spondylosis with radiculopathy.”
Corrected ICD-10-CM Coding:
- M47.22 — Other spondylosis with radiculopathy, cervical region (replaces M47.812 entirely — do NOT code both)
- M54.2 — Cervicalgia (neck pain remains separately documentable)
⚠️ Coding Pitfalls and Tips
| Pitfall or Tip | |
|---|---|
| ❌ | Defaulting to M47.812 for All Cervical Spondylosis Encounters. This is the most commonly cited audit risk — using M47.812 regardless of neurological symptoms. If the documentation supports radiculopathy or myelopathy, the more specific codes (M47.22 or M47.12) are required. Using M47.812 when neuro involvement is documented is a specificity failure and compliance risk. |
| ❌ | Upgrading to M47.22 or M47.12 Based on Imaging Alone. Foraminal stenosis, cord flattening, or “likely nerve root compression” on an MRI report does not justify assigning a myelopathy or radiculopathy code. The treating provider must clinically confirm neurological involvement. Query when in doubt. |
| ❌ | Co-Coding M47.812 with M47.22 or M47.12 for the Same Region. These codes are mutually exclusive for the cervical region. Once myelopathy or radiculopathy is confirmed, M47.812 is retired for that region and the more specific code takes its place. Never stack them. |
| ✅ | Code Cervicalgia (M54.2) Separately When Documented. Neck pain is not bundled into M47.812 per ICD-10-CM guidelines. When the provider documents cervicalgia or neck pain as a presenting symptom or active problem, code it separately to fully represent clinical complexity and support medical necessity for imaging, PT, and injections. |
| ✅ | Watch for Surgical DRG Re-Grouping. When an inpatient admission for M47.812 results in cervical fusion surgery, the case moves from Medical Back DRGs (551-553) to Cervical Spinal Fusion DRGs — a substantial reimbursement difference. Ensure procedure codes accurately reflect all levels fused and the approach to capture the correct surgical DRG. |
| ✅ | Use CDI Queries at Every Cervical Spine Encounter with New Imaging. When a new MRI or CT shows worsening cervical stenosis or foraminal changes, prompt a provider query to document whether neurological status has changed. This drives timely and accurate code updates from M47.812 to M47.22 or M47.12 when clinically appropriate. |