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Spondylolysis, sacral and sacrococcygeal region

ICD10CM code

Medical Policies and Guidelines for Spondylolysis, sacral and sacrococcygeal region

Related policies from health plans

Electrodiagnostic Testing (EMG/NCV) - (CPG129)
Intraoperative Monitoring - (0509)
Peripheral Nerve Destruction for Pain Conditions - (0525)
Sacroiliac Joint Interventions for Pain Management (PDF)

Similar Codes


ICD10CM codes

M43.08 - Spondylolysis, sacral and sacrococcygeal region
M43.07 - Spondylolysis, lumbosacral region
M43.18 - Spondylolisthesis, sacral and sacrococcygeal region
M43.02 - Spondylolysis, cervical region
M43.06 - Spondylolysis, lumbar region
M47.898 - Other spondylosis, sacral and sacrococcygeal region
M43.04 - Spondylolysis, thoracic region
M43.05 - Spondylolysis, thoracolumbar region
M48.38 - Traumatic spondylopathy, sacral and sacrococcygeal region
M45.8 - Ankylosing spondylitis sacral and sacrococcygeal region

HCPCS codes

L0639 - Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sa
L0640 - Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sa
L0630 - Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacr
L0631 - Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extend
L0643 - Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacr
L0628 - Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcyge
L0457 - Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apr
L0648 - Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extend
L0455 - Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra,
L0454 - Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, r

CPT4 codes

72100 - Radiologic examination, spine, lumbosacral; 2 or 3 views
63200 - Laminectomy, with release of tethered spinal cord, lumbar
72265 - Myelography, lumbosacral, radiological supervision and interpretation
63704 - Repair of myelomeningocele; less than 5 cm diameter
49215 - Excision of presacral or sacrococcygeal tumor
01170 - Anesthesia for open procedures involving symphysis pubis or sacroiliac joint
63706 - Repair of myelomeningocele; larger than 5 cm diameter
72202 - Radiologic examination, sacroiliac joints; 3 or more views
63709 - Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy
72120 - Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views