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M49

Non-Billable (Header)

Spondylopathies in diseases classified elsewhere

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

What This Code Means

M49 is the ICD-10-CM diagnosis code for spondylopathies in diseases classified elsewhere. M49 sits in the ICD-10-CM chapter for diseases of the musculoskeletal system and connective tissue (m00-m99), within the section covering spondylopathies (m45-m49).

Header codes like M49 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at M49's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for M49 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • curvature of spine in diseases classified elsewhere
  • deformity of spine in diseases classified elsewhere
  • kyphosis in diseases classified elsewhere
  • scoliosis in diseases classified elsewhere
  • spondylopathy in diseases classified elsewhere

Excludes 1 — Do NOT code together

  • curvature of spine in tuberculosis [Pott's] (A18.01)
  • enteropathic arthropathies (M07.-)
  • gonococcal spondylitis (A54.41)
  • neuropathic [tabes dorsalis] spondylitis (A52.11)
  • neuropathic spondylopathy in syringomyelia (G95.0)
  • neuropathic spondylopathy in tabes dorsalis (A52.11)
  • nonsyphilitic neuropathic spondylopathy NEC (G98.0)
  • spondylitis in syphilis (acquired) (A52.77)
  • tuberculous spondylitis (A18.01)
  • typhoid fever spondylitis (A01.05)

Code First

  • underlying disease, such as:
  • brucellosis (A23.-)
  • Charcot-Marie-Tooth disease (G60.0)
  • enterobacterial infections (A01-A04)
  • osteitis fibrosa cystica (E21.0)

Child Codes

Code Hierarchy

M49Spondylopathies in diseases classified elsewhere
M49Spondylopathies in diseases classified elsewhere

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