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

ICD-10 M96.5

Billable / Specific

Postradiation scoliosis

M96
Block
0
Synonyms
311
LCDs
15
Payer Policies
2
Linked CPTs

About ICD-10-CM M96.5

ICD-10-CM code M96.5 represents Postradiation scoliosis. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M96). The 2026 edition of ICD-10-CM M96.5 became effective on October 1, 2025.

Medicare LCD Coverage for M96.5

Local Coverage Determinations (LCDs) from CMS MACs that list M96.5 as a covered diagnosis.

311 LCDs

Showing top 10 of 311 total . Click a CPT for full coverage scope.

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 →
CMS LCD: Billing and Coding: Somatosensory Testing
Article ID: 57041, Effective: 2026-03-26 00:00:00, 556 covered, 0 non-covered
CPT 95925 →
CMS LCD: Billing and Coding: Somatosensory Testing
Article ID: 57041, Effective: 2026-03-26 00:00:00, 556 covered, 0 non-covered
CPT 95927 →
CMS LCD: Billing and Coding: Somatosensory Testing
Article ID: 57041, Effective: 2026-03-26 00:00:00, 556 covered, 0 non-covered
CPT 95938 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29131 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M96.5.

15 policies

4 Aetna

Orthopedic Casts, Braces and Splints - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0009
Back Pain - Invasive Procedures - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0016
Bone and Tendon Graft Substitutes and Adjuncts
Policy ID: CPB-0411
Positive Pressure Ventilation
Policy ID: CPB-0452

1 Cigna

Transthoracic Echocardiography in Children - (0523)
Policy ID: MM_0523

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: Intraoperative Neurophysiological Testing
Policy ID: ART-56722

CPT Codes Commonly Billed with M96.5

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

2 linkages
  • 22853 Spinal fusion Orthopaedic Surgery
  • 22849 Spinal instrumentation Orthopaedic Surgery

Convert M96.5 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
M96.5 73733 00000

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

Codes Adjacent To M96.5

Other codes in section M96 (Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified).

M96 Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified (non-billable) M96.0 Pseudarthrosis after fusion or arthrodesis M96.1 Postlaminectomy syndrome, not elsewhere classified M96.2 Postradiation kyphosis M96.3 Postlaminectomy kyphosis M96.4 Postsurgical lordosis M96.6 Fracture of bone following insertion of orthopedic implant, joint prosthesis, or bone plate (non-billable) M96.62 Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate (non-billable) M96.621 Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, right arm M96.622 Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, left arm M96.629 Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified arm M96.63 Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate (non-billable) M96.631 Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate, right arm M96.632 Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate, left arm M96.639 Fracture of radius or ulna following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified arm M96.65 Fracture of pelvis following insertion of orthopedic implant, joint prosthesis, or bone plate M96.66 Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate (non-billable) M96.661 Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate, right leg M96.662 Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate, left leg M96.669 Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified leg

ICD-10 M96.5, Billing FAQ

Is ICD-10 code M96.5 billable? +

Yes, M96.5 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 M96.5? +

Procedures frequently paired with M96.5 include: 22853, 22849.

What ICD-9 codes does M96.5 map to? +

Per CMS GEMs, M96.5 maps to ICD-9 codes: 73733. 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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