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

ICD-10 M47.016

Billable / Specific CC

Anterior spinal artery compression syndromes, lumbar region

M47
Block
0
Synonyms
441
LCDs
19
Payer Policies
0
Linked CPTs

About ICD-10-CM M47.016

ICD-10-CM code M47.016 represents Anterior spinal artery compression syndromes, lumbar region. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M47). The 2026 edition of ICD-10-CM M47.016 became effective on October 1, 2025.

Coding Tips for M47.016

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

M47.016 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inpatient DRG Impact, CC

codes Anterior spinal artery compression syndromes, lumbar region. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for M47.016

Local Coverage Determinations (LCDs) from CMS MACs that list M47.016 as a covered diagnosis.

441 LCDs

Showing top 10 of 441 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95909 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95887 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95912 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95999 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95910 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95870 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95860 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95913 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95869 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT G0255 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M47.016.

19 policies

1 Cigna

Intraoperative Monitoring - (0509)
Policy ID: MM_0509

5 Medicare

Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065
Billing and Coding: Nerve Conduction Studies and Electromyography
Policy ID: ART-54969
Billing and Coding: Nerve Conduction Studies and Electromyography
Policy ID: ART-56619

CPT Codes Commonly Billed with M47.016

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

No procedure linkages on file for M47.016

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert M47.016 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
M47.016 7211 10000

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

ICD-10 M47.016, Billing FAQ

Is ICD-10 code M47.016 billable? +

Yes, M47.016 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is M47.016 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What ICD-9 codes does M47.016 map to? +

Per CMS GEMs, M47.016 maps to ICD-9 codes: 7211. 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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