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

ICD-10 M43.27

Billable / Specific

Fusion of spine, lumbosacral region

M43
Block
0
Synonyms
316
LCDs
17
Payer Policies
4
Linked CPTs

About ICD-10-CM M43.27

ICD-10-CM code M43.27 represents Fusion of spine, lumbosacral region. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M43). The 2026 edition of ICD-10-CM M43.27 became effective on October 1, 2025.

Medicare LCD Coverage for M43.27

Local Coverage Determinations (LCDs) from CMS MACs that list M43.27 as a covered diagnosis.

316 LCDs

Showing top 10 of 316 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98942 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98940 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98941 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98943 →
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: Bariatric Surgery Coverage
Article ID: 53026, Effective: 2026-01-01 00:00:00, 553 covered, 0 non-covered
CPT 43846 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M43.27.

17 policies

2 Cigna

Intraoperative Monitoring - (0509)
Policy ID: MM_0509
Peripheral Nerve Destruction for Pain Conditions - (0525) ---- future effective policy
Policy ID: MM_0525

5 Medicare

Billing and Coding: Bariatric Surgery Coverage
Policy ID: ART-53026
Billing and Coding: Home Health Physical Therapy
Policy ID: ART-53058
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065
Billing and Coding: Bariatric Surgery for Treatment of Co-Morbidities Conditions Related to Morbid Obesity
Policy ID: ART-54923
Billing and Coding: Nerve Blockade for Treatment of Chronic Pain and Neuropathy
Policy ID: ART-56034

CPT Codes Commonly Billed with M43.27

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

4 linkages
  • 22845 Spinal osteotomy Orthopaedic Surgery
  • 22830 Spinal decompression Orthopaedic Surgery
  • 27279 CMS LCD: Billing and Coding: Minimally Invasive Arthrodesis of the Sacroiliac Joint (SIJ) CMS LCD
  • 27278 CMS LCD: Billing and Coding: Minimally Invasive Arthrodesis of the Sacroiliac Joint (SIJ) CMS LCD

Convert M43.27 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
M43.27 7246 10000
M43.27 7249 10000

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

ICD-10 M43.27, Billing FAQ

Is ICD-10 code M43.27 billable? +

Yes, M43.27 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 M43.27? +

Procedures frequently paired with M43.27 include: 22845, 22830, 27279, 27278.

What ICD-9 codes does M43.27 map to? +

Per CMS GEMs, M43.27 maps to ICD-9 codes: 7246, 7249. 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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