M46.08
BillableSpinal enthesopathy, sacral and sacrococcygeal region
HCC Category Mapping
V24HCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.307ESRDHCC 40 — Rheumatoid Arthritis and Inflammatory Connective Tissue Disease
0.000What This Code Means
Inflammation of the tendons and ligaments where they attach to the bones in the sacrum and the area at the base of the spine near the tailbone.
Coding Tips
- •Sacral and sacrococcygeal regions are less commonly coded separately; verify documentation distinguishes this from sacroiliitis (M46.1)
- •Consider associated sacroiliac joint involvement which may require additional coding
Clinical Significance
This inflammatory condition affects the sacral and coccygeal spine regions, causing significant pain and mobility issues in the pelvic area. The chronic nature requires ongoing management and significantly impacts sitting tolerance and daily activities.
Documentation Requirements
- ✓Specific anatomical location documented as sacral and sacrococcygeal region
- ✓Evidence of enthesopathy at tendon/ligament attachment sites
- ✓Clinical symptoms including pain, inflammation, or stiffness in sacral area
- ✓Imaging studies confirming enthesopathy (MRI, CT, or specialized views)
- ✓Physical examination findings in sacral/coccygeal region
- ✓Documentation of chronic inflammatory process
- ✓Functional assessment showing impact on sitting or movement
- ✓Differentiation from other causes of tailbone or sacral pain
Commonly Confused Codes
M53.3 — Sacrococcygeal disorders are general, not specific enthesopathyM46.07 — Lumbosacral enthesopathy includes lumbar region, not just sacralS32.2 — Coccyx fracture is traumatic injury, not inflammatory conditionM79.3 — Panniculitis affects different tissue layersK62.89 — Anal pain syndromes are not spinal enthesopathy
Code Hierarchy
└M46Other inflammatory spondylopathies└M46.0Spinal enthesopathy└M46.08Spinal enthesopathy, sacral and sacrococcygeal region
└M46.08Spinal enthesopathy, sacral and sacrococcygeal region