M46.09
BillableSpinal enthesopathy, multiple sites in spine
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 at multiple locations throughout the spine.
Coding Tips
- •Use this code only when enthesopathy affects multiple non-contiguous spinal regions; if confined to one region, use the specific regional code
- •Document all affected spinal regions to justify the 'multiple sites' designation
Clinical Significance
This represents widespread spinal enthesopathy affecting multiple vertebral levels, indicating a more severe and complex inflammatory condition. The multi-site involvement suggests systemic inflammatory disease requiring comprehensive management and monitoring.
Documentation Requirements
- ✓Documentation of enthesopathy at multiple spinal sites
- ✓Specific identification of at least two different spinal regions affected
- ✓Evidence of inflammatory process at multiple tendon/ligament attachments
- ✓Imaging studies showing multi-level involvement
- ✓Clinical examination findings at multiple spinal levels
- ✓Documentation of systemic or widespread nature
- ✓Assessment of overall functional impact across spine
- ✓Exclusion of single-site enthesopathy diagnoses
Commonly Confused Codes
M46.00 — Unspecified spinal enthesopathy doesn't specify multiple sitesM45 — Ankylosing spondylitis has different pathophysiology and treatmentM54.9 — Dorsalgia is general back pain, not inflammatory enthesopathyM79.3 — Panniculitis affects different anatomical structuresM46.06-M46.08 — Single-site enthesopathies are more specific when applicable
Code Hierarchy
└M46Other inflammatory spondylopathies└M46.0Spinal enthesopathy└M46.09Spinal enthesopathy, multiple sites in spine
└M46.09Spinal enthesopathy, multiple sites in spine