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ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 M41.116

Billable / Specific

Juvenile idiopathic scoliosis, lumbar region

M41
Block
0
Synonyms
320
LCDs
13
Payer Policies
5
Linked CPTs

About ICD-10-CM M41.116

ICD-10-CM code M41.116 represents Juvenile idiopathic scoliosis, lumbar region. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M41). The 2026 edition of ICD-10-CM M41.116 became effective on October 1, 2025.

Medicare LCD Coverage for M41.116

Local Coverage Determinations (LCDs) from CMS MACs that list M41.116 as a covered diagnosis.

320 LCDs

Showing top 10 of 320 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Pulmonary Stress Testing
Article ID: 56784, Effective: 2024-10-01 00:00:00, 199 covered, 0 non-covered
CPT 94618 →
CMS LCD: Billing and Coding: Pulmonary Stress Testing
Article ID: 56784, Effective: 2024-10-01 00:00:00, 199 covered, 0 non-covered
CPT 94617 →
CMS LCD: Billing and Coding: Pulmonary Stress Testing
Article ID: 56784, Effective: 2024-10-01 00:00:00, 199 covered, 0 non-covered
CPT 94619 →
CMS LCD: Billing and Coding: Pulmonary Stress Testing
Article ID: 56784, Effective: 2024-10-01 00:00:00, 199 covered, 0 non-covered
CPT 94621 →
CMS LCD: Billing and Coding: Lumbar MRI
Article ID: 57206, Effective: 2025-10-23 00:00:00, 3361 covered, 0 non-covered
CPT Q9953 →
CMS LCD: Billing and Coding: Lumbar MRI
Article ID: 57206, Effective: 2025-10-23 00:00:00, 3361 covered, 0 non-covered
CPT 72148 →
CMS LCD: Billing and Coding: Lumbar MRI
Article ID: 57206, Effective: 2025-10-23 00:00:00, 3361 covered, 0 non-covered
CPT A9585 →
CMS LCD: Billing and Coding: Lumbar MRI
Article ID: 57206, Effective: 2025-10-23 00:00:00, 3361 covered, 0 non-covered
CPT 72158 →
CMS LCD: Billing and Coding: Lumbar MRI
Article ID: 57206, Effective: 2025-10-23 00:00:00, 3361 covered, 0 non-covered
CPT 72149 →
CMS LCD: Billing and Coding: Somatosensory Testing
Article ID: 57041, Effective: 2026-03-26 00:00:00, 556 covered, 0 non-covered
CPT 95926 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M41.116.

13 policies

1 Cigna

Electrodiagnostic Testing (EMG/NCV) - (CPG129)
Policy ID: CPG129_EMG_NCV_SSEP

5 Medicare

Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Home Health Physical Therapy
Policy ID: ART-53058
Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065
Billing and Coding: Lumbar Spinal Fusion
Policy ID: ART-56396

CPT Codes Commonly Billed with M41.116

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

5 linkages
  • 22630 CMS LCD: Billing and Coding: Lumbar Spinal Fusion CMS LCD
  • 22533 CMS LCD: Billing and Coding: Lumbar Spinal Fusion CMS LCD
  • 22612 CMS LCD: Billing and Coding: Lumbar Spinal Fusion CMS LCD
  • 22558 CMS LCD: Billing and Coding: Lumbar Spinal Fusion CMS LCD
  • 22633 CMS LCD: Billing and Coding: Lumbar Spinal Fusion CMS LCD

Convert M41.116 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
M41.116 73730 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 M41.116, Billing FAQ

Is ICD-10 code M41.116 billable? +

Yes, M41.116 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with M41.116? +

Procedures frequently paired with M41.116 include: 22630, 22533, 22612, 22558, 22633.

What ICD-9 codes does M41.116 map to? +

Per CMS GEMs, M41.116 maps to ICD-9 codes: 73730. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on July 16, 2026.

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