M46.57 Other infective spondylopathies, lumbosacral region

ICD-10-CM Code M46.57: Other infective spondylopathies, lumbosacral region

ICD-10-CM code M46.57 identifies other infective spondylopathies located in the lumbosacral region. This diagnostic code captures infectious or infective spondylitis, spondylodiscitis, or vertebral osteomyelitis at this specific spinal level. It excludes conditions like tuberculous spondylitis and discitis, which route to different clinical classifications. 3 4

Plain-language overview

Code M46.57 represents an infective spondylopathy located specifically in the lumbosacral region of the spine. This classification applies when a provider documents infectious spondylitis, spondylodiscitis, or vertebral osteomyelitis at this anatomical level. 3

What this code represents

The M46.5x code series categorizes infective spondylopathies by distinct anatomical regions, and M46.57 specifically captures the lumbosacral level. This distinguishes it from adjacent codes like M46.56, which applies to the lumbar region, and M46.58, which covers the sacral and sacrococcygeal region. 4

Documentation considerations

Clinical documentation must specify the anatomical level as lumbosacral or L5-S1 to support M46.57. Documentation listing a generic lumbar level without lumbosacral detail defaults to M46.56, not M46.57. 3

If the infection is confined to the disc space and documented as discitis, the correct parent subcategory is M46.47. Coders must distinguish this from M46.57, which is used for other infective spondylopathies not classified elsewhere. 3

Coding details

The Tabular List instructs coders to pair M46.57 with an additional code from categories B95–B97 to identify the causative organism. This coding rule applies when the causative organism falls outside the more specific M46.5x exclusions. 3

M46.57 is not used for tuberculous spondylitis at the lumbosacral level. Documentation of tuberculosis spondylitis routes to code M49.07 for spondylopathy in tuberculosis at the lumbosacral region. 3

Coverage and utilization context

Medicare billing articles list M46.57 within the context of lumbar MRI utilization. These articles establish that lumbar MRI abnormalities alone do not validate the need for the test without other supporting clinical rationale. 1 2

What the sources add

While the Medicare articles establish that imaging abnormalities alone do not justify testing without clinical rationale, the coding reference details the specific anatomical and etiological documentation needed to select M46.57. These sources provide distinct operational and coding context for this diagnosis. 1 3

Questions to verify

Does the clinical documentation explicitly specify the lumbosacral anatomical level rather than a generic lumbar region? Verifying this precise anatomical detail is necessary to distinguish M46.57 from M46.56. 3

Sources

1. Article - Billing and Coding: Lumbar MRI (A57207) — cms.gov; accessed 2026-07-26.
2. Article - Billing and Coding: Lumbar MRI (A57206) — cms.gov; accessed 2026-07-26.
3. ICD-10 M46.57 - Other infective spondylopathies, lumbosacral region | Mira Health — mirahealth.care; accessed 2026-07-26.
4. ICD-9-CM to ICD-10-CM Crosswalk: Common Pain Diagnoses — s28.q4cdn.com; accessed 2026-07-26.