{"code":"M43.25","type":"code","title":"Fusion of spine, thoracolumbar region","codeAlso":[],"includes":[],"modern_v":"official26","codeFirst":[],"excludes1":["ankylosing spondylitis (M45.0-)","congenital fusion of spine (Q76.4)","congenital spondylolysis and spondylolisthesis (Q76.2)","hemivertebra (Q76.3-Q76.4)","Klippel-Feil syndrome (Q76.1)","lumbarization and sacralization (Q76.4)","platyspondylisis (Q76.4)","spina bifida occulta (Q76.0)","spinal curvature in osteoporosis (M80.-)","spinal curvature in Paget's disease of bone [osteitis deformans] (M88.-)"],"excludes2":["arthrodesis status (Z98.1)","pseudoarthrosis after fusion or arthrodesis (M96.0)"],"isBillable":true,"fyEffectivity":{"fy2026":true,"fy2027":true,"billableFy2026":true,"billableFy2027":true},"inclusionTerms":[],"useAdditionalCode":[],"clinicalDefinition":"Fusion of spine, thoracolumbar region is a billable ICD-10-CM diagnosis code (M43.25). Excludes1 (not coded here): ankylosing spondylitis (M45.0-); congenital fusion of spine (Q76.4); congenital spondylolysis and spondylolisthesis (Q76.2); hemivertebra (Q76.3-Q76.4); Klippel-Feil syndrome (Q76.1); lumbarization and sacralization (Q76.4); platyspondylisis (Q76.4); spina bifida occulta (Q76.0); spinal curvature in osteoporosis (M80.","officialDefinition":"Fusion of spine, thoracolumbar region is a billable ICD-10-CM diagnosis code (M43.25). Excludes1 (not coded here): ankylosing spondylitis (M45.0-); congenital fusion of spine (Q76.4); congenital spondylolysis and spondylolisthesis (Q76.2); hemivertebra (Q76.3-Q76.4); Klippel-Feil syndrome (Q76.1); lumbarization and sacralization (Q76.4); platyspondylisis (Q76.4); spina bifida occulta (Q76.0); spinal curvature in osteoporosis (M80.-); spinal curvature in Paget's disease of bone [osteitis deformans] (M88.-). Excludes2 (not included here): arthrodesis status (Z98.1); pseudoarthrosis after fusion or arthrodesis (M96.0).","seventhCharacterInstructions":[],"workflowProtocols":[],"guidelines":{"whenToUse":[],"whenNotToUse":[],"commonBillingMistakes":[],"codeComparisons":[],"documentationChecklist":[]},"domainLandscape":{"summary":"Primary diagnostic domain and clinical landscape evaluation.","keyCategories":[],"diagnosticContinuum":"Progression continuum from acute presentation to resolution."},"children":[],"hierarchy":[],"relatedCodes":[],"relevantCPTCodes":[],"documentationTips":[],"caseStudies":[],"description":"","overview":"","noteProvenance":{"congenital spondylolysis and spondylolisthesis (Q76.2)":"M43","hemivertebra (Q76.3-Q76.4)":"M43","Klippel-Feil syndrome (Q76.1)":"M43","lumbarization and sacralization (Q76.4)":"M43","platyspondylisis (Q76.4)":"M43","spina bifida occulta (Q76.0)":"M43","spinal curvature in osteoporosis (M80.-)":"M43","spinal curvature in Paget's disease of bone [osteitis deformans] (M88.-)":"M43","ankylosing spondylitis (M45.0-)":"M43.2","congenital fusion of spine (Q76.4)":"M43.2","arthrodesis status (Z98.1)":"M43.2","pseudoarthrosis after fusion or arthrodesis (M96.0)":"M43.2","Ankylosis of spinal joint":"M43.2"},"hcc":{"mapped":false,"model":"CMS-HCC V28","paymentYear":"2026","categories":[],"otherModels":[]}}