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Home/Diagnosis/ICD-10 Coding for Sacroiliac Joint Syndrome

ICD-10 Coding for Sacroiliac Joint Syndrome

M46.1
M53.3

Complete ICD-10-CM coding and documentation guide for icd-10 coding for sacroiliac joint syndrome includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
SI Joint Dysfunction
Sacroiliitis
si joint syndrome
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Key Information: ICD-10 Coding for Sacroiliac Joint Syndrome

Essential facts and insights about ICD-10 Coding for Sacroiliac Joint Syndrome

Use ICD-10 code M46.1 for sacroiliitis, not elsewhere classified, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Sacroiliitis, not elsewhere classified

Billable Code
M46.1
Billable

Diagnostic Criteria

clinical:
  • • Imaging shows subchondral sclerosis or erosions.
documentation:
  • • Documented imaging evidence of inflammation.

Applicable To

  • • Inflammation of the sacroiliac joint

Important Notes

  • • Ensure imaging reports are linked to the encounter to validate M46.1.

Sacrococcygeal disorders, not elsewhere classified

Billable Code
M53.3
Billable

Diagnostic Criteria

clinical:
  • • Physical exam findings such as positive provocative tests (e.g., FABER, Gaenslen’s)

Applicable To

  • • Mechanical dysfunction of the sacroiliac joint

Important Notes

  • • Ensure physical exam findings are well-documented.
Ancillary Codes

Additional codes that may be used with this diagnosis

R10.2

Pelvic and perineal pain

Use for symptom reporting when pelvic pain is documented.

M99.0

Segmental and somatic dysfunction of the sacroiliac region

Use when instability or hypermobility is noted.

Frequently Asked Questions

What is the ICD-10 code for sacroiliac joint syndrome?

The ICD-10 code for sacroiliac joint syndrome is M46.1 when imaging confirms inflammation, or M53.3 for mechanical dysfunction without inflammation.

When should M46.1 be used?

Use M46.1 when imaging, such as MRI or CT, confirms inflammation of the sacroiliac joint.

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