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

ICD-10 M48.34

Billable / Specific CC

Traumatic spondylopathy, thoracic region

M48
Block
0
Synonyms
420
LCDs
14
Payer Policies
0
Linked CPTs

About ICD-10-CM M48.34

ICD-10-CM code M48.34 represents Traumatic spondylopathy, thoracic region. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M48). The 2026 edition of ICD-10-CM M48.34 became effective on October 1, 2025.

Coding Tips for M48.34

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

Inpatient DRG impact: CC

M48.34 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 Traumatic spondylopathy, thoracic region. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for M48.34

Local Coverage Determinations (LCDs) from CMS MACs that list M48.34 as a covered diagnosis.

420 LCDs

Showing top 10 of 420 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: 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 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M48.34.

14 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: 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: Chiropractic Services
Policy ID: ART-56273

CPT Codes Commonly Billed with M48.34

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

No procedure linkages on file for M48.34

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 M48.34 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
M48.34 7217 10000

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

ICD-10 M48.34, Billing FAQ

Is ICD-10 code M48.34 billable? +

Yes, M48.34 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is M48.34 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 M48.34 map to? +

Per CMS GEMs, M48.34 maps to ICD-9 codes: 7217. 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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