ICD-10 M43.07
Billable / SpecificSpondylolysis, lumbosacral region
About ICD-10-CM M43.07
ICD-10-CM code M43.07 represents Spondylolysis, lumbosacral region. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M43). The 2026 edition of ICD-10-CM M43.07 became effective on October 1, 2025.
Medicare LCD Coverage for M43.07
Local Coverage Determinations (LCDs) from CMS MACs that list M43.07 as a covered diagnosis.
Showing top 10 of 176 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing M43.07.
3 Cigna
5 Medicare
CPT Codes Commonly Billed with M43.07
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 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 M43.07 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| M43.07 | 7384 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To M43.07
Other codes in section M40-M43 (Deforming dorsopathies).
ICD-10 M43.07, Billing FAQ
Is ICD-10 code M43.07 billable? +
Yes, M43.07 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 M43.07? +
Procedures frequently paired with M43.07 include: 22630, 22533, 22612, 22558, 22633.
What ICD-9 codes does M43.07 map to? +
Per CMS GEMs, M43.07 maps to ICD-9 codes: 7384. 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 May 31, 2026.
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