QUESTION: Dr Kolar, “I have heard there are new diagnosis codes for 2025. Do any of them relate to personal injury?”
ANSWER: Yes, there are many ICD-10 code updates that physical therapists, chiropractors, medical doctors and other healthcare providers that treat personal injury patients should be aware of because they relate to back pain and spinal disc pathology.
The official ICD-10 code guidelines for 2025 take effect on October 1, 2024, and remain in effect until September 30, 2025. The updates include 252 new codes, 36 deleted codes, and 13 codes were revised.
There are 8 new ICD-10 codes that relate to low back pain, lower extremity pain and disc degeneration:
- M51.360: Other intervertebral disc degeneration, lumbar region with discogenic back pain only
- MSL361 Other intervertebral disc degeneration, lumbar region with lower extremity pain only
- M51.362: Other intervertebral disc degeneration, lumbar region with discogenic back pain and lower extremity pain
- MS1.369: Other intervertebral disc degeneration, lumbar region without mention of lumbar back pain or lower extremity pain
- M51.370: Other intervertebral disc degeneration, lumbosacral region with discogenic back pain only
- M51-371: Other intervertebral disc degeneration, lumbosacral region with lower extremity pain only
- M51372: Other intervertebral disc degeneration, lumbosacral region with discogenic back pain and lower extremity pain
- M51.379: Other intervertebral disc degeneration, lumbosacral region without mention of lumbar hack pain or lower extremity pain
There is 1 new ICD-10 code that relates to low back muscle dysfunction:
- M62.85: Dysfunction of the multifidus muscles, lumbar region
There are 5 new shoulder ICD-10 codes:
- M65.90: Unspecified synovitis and tenosynovitis, unspecified site
- M65.91: Unspecified synovitis and tenosynovitis, shoulder
- M65.911. Unspecified synovitis and tenosynovitis, right shoulder
- M65.912: Unspecified synovitis and tenosynovitis, left shoulder
- M65.919. Unspecified synovitis and tenosynovitis, unspecified shoulder
There are a new upper arm ICD-10 codes:
- M65.92: Unspecified synovitis and tenosynovitis, upper arm
- M65.9211 Unspecified synovitis and tenosynovitis, tight upper arm
- M65.azz: Unspecified synovitis and tenosynovitis, left upper arm
- M65.929: Unspecified synovitis and tenosynovitis, unspecified upper arm
There are a new thigh ICD-10 codes:
- M65-95: Unspecified synovitis and tenosynovi tis, thigh
- M65.951: Unspecified synovitis and tenosynovitis, right thigh
- M65.952: Unspecified synovitis and tenosynovitis, left thigh
- M65.959: Unspecified synovitis and tenosynovitis, unspecified thigh
There are 4 new ankle and foot ICD-10 codes:
- M65.97: Unspecified synovitis and tenosynovitis, ankle and foot
- M65/971: Unspecified synovitis and tenosynovitis, right ankle and foot
- M65.972: Unspecified synovitis and tenosynovitis, left ankle and foot
- M65.979: Unspecified synovitis and tenosynovitis, unspecified ankle and foot
The official ICD-10 code guidelines for 2025 take effect on October 1, 2024, and remain in effect until September 30, 2025.
Additional Comments
Acute traumatic versus chronic or recurrent musculoskeletal conditions. Many musculoskeletal conditions are a result of previous injury or trauma to a site or are recurrent conditions. Bone, joint or muscle conditions that are the result of a healed injury are usually found in chapter 13 of the Tabular List. Email info@target- coding.com for a copy of the Tabular List.
In ICD-10, the trauma episodes of care are designated by 3 types of encounters. Initial encounter, subsequent encounter and sequelae. Use the letter A for initial encounter. This occurs when the patient is receiving active treatment for the condition, and you are the first provider the patient visits for the present condition. Use the letter D for subsequent encounters. This is for follow up visits after the patient has seen another provider. Use the letter S for sequela. Sequela is a late effect problem as a result of the original problem. This is used for complications or conditions that arise as a direct result of a condition.
If you’d like to know the ICD-10 codes that pay for the most treatment, email info@targetcoding.com to receive a FREE ICD-10 code cheat sheet.
Marty Kotlar, DC, CPCO, CBCS, COF
TARGET CODING
