Accurate chiropractic diagnosis is the cornerstone of effective patient care and streamlined billing. For every patient encounter, detailing diagnoses, symptoms, and procedures using Chiropractic ICD-10 codes is not just best practice—it’s essential. These ICD-10 codes (International Classification of Diseases, Tenth Revision) are vital for record-keeping and play a pivotal role in chiropractic billing and insurance reimbursements. Coding errors are a common cause of claim denials, highlighting the importance of using valid diagnosis codes to ensure proper claim payments and to substantiate the medical necessity of services during reviews or audits.
The ICD-10 system is extensive, with over 70,000 codes in the fiscal year 2024, including recent updates that added 395 new codes, removed 25, and modified 22. Navigating this complex system can be challenging, which is why we’ve developed this Chiropractic Diagnosis Sheet. This sheet serves as a practical guide to ICD-10 codes specifically for musculoskeletal diseases commonly seen in chiropractic practice.
This ICD-10 codes cheat sheet is intended as a helpful reference for coding and diagnosis in chiropractic settings. It is important to remember that this is not an exhaustive list of all ICD-10 codes accepted by insurance payers, but it covers many of the most frequently used codes.
Migraine Diagnosis Codes
Migraines are characterized by severe throbbing pain or a pulsing sensation, typically affecting one side of the head. Often accompanied by symptoms like nausea, vomiting, and heightened sensitivity to light and sound, migraines can significantly impact a patient’s quality of life. Here are frequently utilized chiropractic ICD-10 codes for documenting migraine diagnoses:
| Code | Code Description |
|---|---|
| G43.001 | Migraine without aura, not intractable with status migrainosus |
| G43.009 | Migraine without aura, not intractable without status migrainosus |
| G43.011 | Migraine without aura, intractable with status migrainosus |
| G43.019 | Migraine without aura, intractable without status migrainosus |
| G43.101 | Migraine with aura, not intractable with status migrainosus |
| G43.109 | Migraine with aura, not intractable without status migrainosus |
| G43.111 | Migraine with aura, intractable with status migrainosus |
| G43.119 | Migraine with aura, intractable without status migrainosus |
| G43.401 | Hemiplegic migraine, not intractable with status migrainosus |
| G43.409 | Hemiplegic migraine, not intractable without status migrainosus |
| G43.411 | Hemiplegic migraine, intractable with status migrainosus |
| G43.419 | Hemiplegic migraine, intractable without status migrainosus |
| G43.501 | Persistent migraine aura without cerebral infarction, not intractable with status migrainosus |
| G43.509 | Persistent migraine aura without cerebral infarction, not intractable without status migrainosus |
| G43.511 | Persistent migraine aura without cerebral infarction, intractable with status migrainosus |
| G43.519 | Persistent migraine aura without cerebral infarction, intractable without status migrainosus |
| G43.601 | Persistent migraine aura with cerebral infarction, not intractable with status migrainosus |
| G43.609 | Persistent migraine aura with cerebral infarction, not intractable without status migrainosus |
| G43.611 | Persistent migraine aura with cerebral infarction, intractable with status migrainosus |
| G43.619 | Persistent migraine aura with cerebral infarction, intractable without status migrainosus |
| G43.701 | Chronic migraine without aura, not intractable with status migrainosus |
| G43.709 | Chronic migraine without aura, not intractable without status migrainosus |
| G43.711 | Chronic migraine without aura, intractable with status migrainosus |
| G43.719 | Chronic migraine without aura, intractable without status migrainosus |
| G43.A0 | Cyclical vomiting in migraine, not intractable |
| G43.A1 | Cyclical vomiting in migraine, intractable |
| G43.B0 | Ophthalmoplegic migraine not intractable |
| G43.B1 | Ophthalmoplegic migraine intractable |
| G43.C0 | Periodic headache syndromes in child or adult not intractable |
| G43.C1 | Periodic headache syndromes in child or adult intractable |
| G43.D0 | Abdominal migraine not intractable |
| G43.D1 | Abdominal migraine intractable |
| G43.801 | Other migraine, not intractable with status migrainosus |
| G43.809 | Other migraine, not intractable without status migrainosus |
| G43.811 | Other migraine, intractable with status migrainosus |
| G43.819 | Other migraine, intractable without status migrainosus |
| G43.821 | Menstrual migraine, not intractable with status migrainosus |
| G43.829 | Menstrual migraine, not intractable without status migrainosus |
| G43.831 | Menstrual migraine, intractable with status migrainosus |
| G43.839 | Menstrual migraine, intractable without status migrainosus |
| G43.901 | Migraine, unspecified, not intractable with status migrainosus |
| G43.909 | Migraine, unspecified, not intractable without status migrainosus |
| G43.911 | Migraine, unspecified, intractable with status migrainosus |
| G43.919 | Migraine, unspecified, intractable without status migrainosus |
Type 1 Excludes for Migraine Codes
- headache NOS (R51.9)
- lower half migraine (G44.00)
Type 2 Excludes for Migraine Codes
- headache syndromes (G44.-)
Back Pain Diagnosis Codes
Back pain is a frequent complaint addressed in chiropractic settings, ranging from mild discomfort to severe, debilitating pain. Its origins are diverse, affecting individuals across all age groups. Upper back pain can stem from aortic disorders or spinal inflammation, among other causes. Lower back pain can be associated with issues in the lumbar spine, intervertebral discs, spinal ligaments, spinal cord and nerves, lower back muscles, and even internal abdominal and pelvic organs.
Below are common ICD-10 chiropractic codes for diagnosing and documenting various types of back pain:
| Code | Code Description |
|---|---|
| M54.10 | Radiculopathy, site unspecified |
| M54.11 | Radiculopathy, occipito-atlanto-axial region |
| M54.12 | Radiculopathy, cervical region |
| M54.13 | Radiculopathy, cervicothoracic region |
| M54.14 | Radiculopathy, thoracic region |
| M54.15 | Radiculopathy, thoracolumbar region |
| M54.16 | Radiculopathy, lumbar region |
| M54.17 | Radiculopathy, lumbosacral region |
| M54.18 | Radiculopathy, sacral and sacrococcygeal region |
| M54.2 | Cervicalgia |
| M54.30 | Sciatica, unspecified side |
| M54.31 | Sciatica, right side |
| M54.32 | Sciatica, left side |
| M54.40 | Lumbago with sciatica, unspecified side |
| M54.41 | Lumbago with sciatica, right side |
| M54.42 | Lumbago with sciatica, left side |
| M54.5 | Low back pain |
| M54.6 | Pain in thoracic spine |
| M54.81 | Occipital neuralgia |
| M54.89 | Other dorsalgia |
| M54.9 | Dorsalgia, unspecified |
Cervical Pain Disorder Diagnosis Codes
Cervicalgia, widely known as neck pain, is a common condition affecting a significant majority of individuals at some point in their lives. Terms frequently used interchangeably with cervical pain include neck pain, acute neck pain (lasting less than 3 months), chronic neck pain, pain in the cervical spine (both acute and chronic), and chronic neck pain (extending beyond 3 months).
The subsequent table details commonly used ICD-10 chiropractic codes specifically for Cervical Pain Disorders, aiding in precise diagnosis and documentation:
| Codes | Code Description |
|---|---|
| M50.90 | Cervical disc disorder, unspecified, unspecified cervical region |
| M50.00 | Cervical disc disorder with myelopathy, unspecified cervical region |
| M50.01 | Cervical disc disorder with myelopathy, occipito-atlanto-axial region |
| M50.02 | Cervical disc disorder with myelopathy, mid-cervical region |
| M50.03 | Cervical disc disorder with myelopathy, cervicothoracic region |
| M50.10 | Cervical disc disorder with radiculopathy, unspecified cervical region |
| M50.11 | Cervical disc disorder with radiculopathy, occipito-atlanto-axial region |
| M50.12 | Cervical disc disorder with radiculopathy, mid-cervical region |
| M50.13 | Cervical disc disorder with radiculopathy, cervicothoracic region |
| M50.20 | Other cervical disc displacement, unspecified cervical region |
| M50.21 | Other cervical disc displacement, occipito-atlanto-axial region |
| M50.22 | Other cervical disc displacement, mid-cervical region |
| M50.23 | Other cervical disc displacement, cervicothoracic region |
| M50.30 | Other cervical disc degeneration, unspecified cervical region |
| M50.31 | Other cervical disc degeneration, occipito-atlanto-axial region |
| M50.32 | Other cervical disc degeneration, mid-cervical region |
| M50.33 | Other cervical disc degeneration, cervicothoracic region |
| M50.80 | Other cervical disc disorders, unspecified cervical region |
| M50.81 | Other cervical disc disorders, occipito-atlanto-axial region |
| M50.82 | Other cervical disc disorders, mid-cervical region |
| M50.83 | Other cervical disc disorders, cervicothoracic region |
| M50.91 | Cervical disc disorder, unspecified, occipito-atlanto-axial region |
| M50.92 | Cervical disc disorder, unspecified, mid-cervical region |
| M50.93 | Cervical disc disorder, unspecified, cervicothoracic region |
| Z03.75 | Encounter for suspected cervical shortening ruled out |
Sciatica Diagnosis Codes
Sciatica, also known as lumbar radiculopathy, arises from injury or compression of the sciatic nerve. This major nerve originates in the hip and extends down the leg to the knee. Conditions such as herniated discs, degenerative disc disease, spinal stenosis, foraminal stenosis, spondylolisthesis, and osteoarthritis can lead to sciatica.
The following are commonly employed ICD-10 codes for diagnosing sciatica, categorized by the level of specificity available:
| Codes | Code Description |
|---|---|
| M54.30 | Sciatica, unspecified side |
| M54.31 | Sciatica, right side |
| M54.32 | Sciatica, left side |
| M54.3 | Sciatica |
Radiculopathy Diagnosis Codes
M54.12 is the designated ICD-10-CM code for Radiculopathy in the Cervical Region, essential for precise classification and documentation.
Here are frequently used ICD-10 chiropractic codes for radiculopathy, organized by the degree of specificity to aid in accurate diagnosis:
| Codes | Code Description |
|---|---|
| M54.10 | Radiculopathy – site unspecified |
| M54.11 | Radiculopathy occipito-atlanto-axial region |
| M54.12 | Radiculopathy cervical region |
| M54.13 | Radiculopathy – cervicothoracic region |
| M54.14 | Radiculopathy – thoracic region |
| M54.15 | Radiculopathy – thoracolumbar region |
| M54.16 | Radiculopathy – lumbar region |
| M54.17 | Radiculopathy – lumbosacral region |
| M54.18 | Radiculopathy – sacral and sacrococcygeal region |
Synonyms for Radiculopathy
- Cervical radiculopathy
- Cervical nerve root compression
- Cervical nerve root irritation
- Cervical nerve root disorder
- Cervical radicular syndrome
Sprains and Strains Diagnosis Codes
A sprain occurs when a joint is forced out of its normal position by trauma, such as a fall or blow, leading to overstretched or torn ligaments. Chronic strains result from repetitive muscle and tendon movements over time.
ICD-10 provides numerous codes for sprains and strains, differentiated by the specific location and the stage of treatment. Below are some examples relevant to chiropractic practice:
| Codes | Code Description |
|---|---|
| S73.1 | Sprain of hip |
| S73.10 | Unspecified sprain of hip |
| S73.101 | Unspecified sprain of right hip |
| S73.101A | Unspecified sprain of right hip, initial encounter |
| S73.101D | Unspecified sprain of right hip, subsequent encounter |
| S73.101S | Unspecified sprain of right hip, sequela |
| S73.102 | Unspecified sprain of left hip |
| S73.102A | Unspecified sprain of left hip, initial encounter |
| S73.102D | Unspecified sprain of left hip, subsequent encounter |
| S73.102S | Unspecified sprain of left hip, sequela |
| S73.109 | Unspecified sprain of unspecified hip |
| S73.109A | Unspecified sprain of unspecified hip, initial encounter |
| S73.109D | Unspecified sprain of unspecified hip, subsequent encounter |
| S73.109S | Unspecified sprain of unspecified hip, sequela |
| S73.11 | Iliofemoral ligament sprain of hip |
| S73.19: | Other sprain of hip |
| S73.191 | Other sprain of right hip |
| S73.191A | Other sprain of right hip, initial encounter |
| S73.191D | Other sprain of right hip, subsequent encounter |
| S73.191S | Other sprain of right hip, sequela |
| S73.192 | Other sprain of left hip |
| S73.192A | Other sprain of left hip, initial encounter |
| S73.192D | Other sprain of left hip, subsequent encounter |
| S73.192S | Other sprain of left hip, sequela |
| S73.199 | Other sprain of unspecified hip |
| S73.199A | Other sprain of unspecified hip, initial encounter |
| S73.199D | Unspecified sprain of unspecified hip, subsequent encounter |
| S73.199S | Unspecified sprain of unspecified hip, sequela |
| S13.4XXA | Sprain of ligaments of cervical spine – initial encounter |
| S23.3XXA | Sprain of ligaments of thoracic spine – initial encounter |
| S33.5XXA – | Sprain of ligaments of lumbar spine – initial encounter |
| S33.6XXA | Sprain of sacroiliac joint – initial encounter |
Spondylosis Diagnosis Codes
Spondylosis is a degenerative condition affecting the spine, potentially leading to structural and functional impairment. Accurate diagnosis involves assessing affected nerves, bones, and muscles, along with evaluating the movement capabilities of the impacted areas.
ICD-10 codes for spondylosis used in chiropractic diagnosis sheets are detailed below:
| Codes | Code Description |
|---|---|
| M47 | Spondylosis |
| M47.0 | Anterior spinal and vertebral artery compression syndromes |
| M47.01 | Anterior spinal artery compression syndromes |
| M47.011 | Anterior spinal artery compression syndromes, occipito-atlanto-axial region |
| M47.012 | Anterior spinal artery compression syndromes, cervical region |
| M47.013 | Anterior spinal artery compression syndromes, cervicothoracic region |
| M47.014 | Anterior spinal artery compression syndromes, thoracic region |
| M47.015 | Anterior spinal artery compression syndromes, thoracolumbar region |
| M47.016 | Anterior spinal artery compression syndromes, lumbar region |
| M47.019 | Anterior spinal artery compression syndromes, site unspecified |
| M47.02 | Vertebral artery compression syndromes |
| M47.021 | Vertebral artery compression syndromes, occipito-atlanto-axial region |
| M47.022 | Vertebral artery compression syndromes, cervical region |
| M47.029 | Vertebral artery compression syndromes, site unspecified |
| M47.1 | Other spondylosis with myelopathy |
| M47.10 | Other spondylosis with myelopathy, site unspecified |
| M47.11 | Other spondylosis with myelopathy, occipito-atlanto-axial region |
| M47.12 | Other spondylosis with myelopathy, cervical region |
| M47.13 | Other spondylosis with myelopathy, cervicothoracic region |
| M47.14 | Other spondylosis with myelopathy, thoracic region |
| M47.15 | Other spondylosis with myelopathy, thoracolumbar region |
| M47.16 | Other spondylosis with myelopathy, lumbar region |
| M47.2 | Other spondylosis with radiculopathy |
| M47.20 | Other spondylosis with radiculopathy, site unspecified |
| M47.21 | Other spondylosis with radiculopathy, occipito-atlanto-axial region |
| M47.22 | Other spondylosis with radiculopathy, cervical region |
| M47.23 | Other spondylosis with radiculopathy, cervicothoracic region |
| M47.24 | Other spondylosis with radiculopathy, thoracic region |
| M47.25 | Other spondylosis with radiculopathy, thoracolumbar region |
| M47.26 | Other spondylosis with radiculopathy, lumbar region |
| M47.27 | Other spondylosis with radiculopathy, lumbosacral region |
| M47.28 | Other spondylosis with radiculopathy, sacral and sacrococcygeal region |
| M47.8 | Other spondylosis |
| M47.81 | Spondylosis without myelopathy or radiculopathy |
| M47.811 | Spondylosis without myelopathy or radiculopathy, occipito-atlanto-axial region |
| M47.812 | Spondylosis without myelopathy or radiculopathy, cervical region |
| M47.813 | Spondylosis without myelopathy or radiculopathy, cervicothoracic region |
| M47.814 | Spondylosis without myelopathy or radiculopathy, thoracic region |
| M47.815 | Spondylosis without myelopathy or radiculopathy, thoracolumbar region |
| M47.816 | Spondylosis without myelopathy or radiculopathy, lumbar region |
| M47.817 | Spondylosis without myelopathy or radiculopathy, lumbosacral region |
| M47.818 | Spondylosis without myelopathy or radiculopathy, sacral and sacrococcygeal region |
| M47.819 | Spondylosis without myelopathy or radiculopathy, site unspecified |
| M47.89 | Other spondylosis |
| M47.891 | Other spondylosis, occipito-atlanto-axial region |
| M47.892 | Other spondylosis, cervical region |
| M47.893 | Other spondylosis, cervicothoracic region |
| M47.894 | Other spondylosis, thoracic region |
| M47.895 | Other spondylosis, thoracolumbar region |
| M47.896 | Other spondylosis, lumbar region |
| M47.897 | Other spondylosis, lumbosacral region |
| M47.898 | Other spondylosis, sacral and sacrococcygeal region |
| M47.899 | Other spondylosis, site unspecified |
| M47.9 | Spondylosis, unspecified |
Conclusion: Utilizing Your Chiropractic Diagnosis Sheet
In conclusion, the chiropractic diagnosis codes you employ in patient documentation must accurately reflect the neuromusculoskeletal (NMS) conditions and the specific body areas requiring treatment. When submitting claims, the primary ICD-10 code representing the main reason for the encounter should always be listed first. Supplementary ICD-10 codes (secondary, tertiary, and quaternary) should then be used to detail any additional conditions or treatment areas.
This chiropractic billing and diagnosis sheet, which compiles frequently used ICD-10 codes, is a valuable tool designed to streamline your coding and billing processes, ensuring meticulous documentation. By effectively using these codes, your billing staff can improve efficiency, expedite claims processing, and ultimately enhance revenue cycle management.
[Read: The Complete Guide To Chiropractic Billing]
Chiropractic billing can indeed be complex. For practices handling a large volume of claims daily, outsourcing billing operations allows you to concentrate on patient care. At zHealth, our billing experts manage your coding, claims, appeals, denials, A/R, and all other billing-related tasks. To discover how zHealth’s specialized chiropractic billing services can accelerate your payments, we invite you to request a complimentary billing analysis.
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