M45 ICD-10-CM Code: Ankylosing spondylitis
Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.
Coding at a Glance
- Tabular directives
- 1 inclusion term · 2 Excludes1 · 1 Excludes2
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for M45 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025
Inclusion Terms
Alternative terms the tabular list files under this code.
- Rheumatoid arthritis of spine
Excludes1 — Not Coded Here
Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
- arthropathy in Reiter's disease (M02.3-) Compare M45 vs M02.3 →
- juvenile (ankylosing) spondylitis (M08.1) Compare M45 vs M08.1 →
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- Behçet's disease (M35.2) Compare M45 vs M35.2 →
Coder workflow for M45
MedCoder structured workflow — derived from this code’s own official record
Before you code M45
- M45 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).
ReviewM45.0, M45.1, M45.2, M45.3, M45.4, M45.5, M45.6, M45.7, M45.8, M45.9, M45.A
See the relationships section · Guide: How to choose an ICD-10-CM code →
- Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with M45. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).
Choose the right path
- Does the documentation support one of the more specific codes beneath M45?
Yes → Select that code and continue the checks below on its own page.
No → M45 cannot be reported as written; query for the specificity its subcategory needs.ReviewM45.0, M45.1, M45.2, M45.3, M45.4, M45.5, M45.6, M45.7, M45.8, M45.9, M45.A
- Does the documentation support a condition named in M45’s Excludes1 note?
Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
No → Continue.
Consider M45. Then confirm the code is valid for the date of service in the Verify section.
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Official instructions as workflow
Excludes1 — check before selecting M45(2 notes)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with M45: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.
See the official tabular notes · Guidelines I.A.12.a
Excludes2 — not part of M45(1 note)
Coding workflow: The conditions named in this note are not included in M45. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
CompareM35.2
See the official tabular notes · Guidelines I.A.12.b
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: Both the condition M45 describes and a condition named in its Excludes1 note are documented for the same encounter.
Coding question: Can both codes be reported?
Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.
Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Verify Before Coding
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
MedCoder structured relationships — computed from published CMS and AHRQ datasets
Other codes that name M45 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.
Referenced by 2 Excludes1 notes across 2 chapters: G55 — Nerve root and plexus compressions in diseases classified elsewhere, M05 — Rheumatoid arthritis with rheumatoid factor.
These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.
Referenced by 7 Excludes2 notes: M20 — Acquired deformities of fingers and toes, M20-M25 — Other joint disorders (M20-M25), M21 — Other acquired deformities of limbs, M22 — Disorder of patella, M23 — Internal derangement of knee, M24 — Other specific joint derangements, M25 — Other joint disorder, not elsewhere classified.
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
Referenced by 1 Code First instruction: J99 — Respiratory disorders in diseases classified elsewhere.
Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.
Contextual Map
Every relationship of M45 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Run M45 with these 13 related codes in Claim Check
Hierarchy
- M00-M99 — Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) (M00-M99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M45-M49 — Spondylopathies[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Excludes1
- M02.3 — Reiter's disease[Excludes1]: “arthropathy in Reiter's disease (M02.3-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- M08.1 — Juvenile ankylosing spondylitis[Excludes1]: “juvenile (ankylosing) spondylitis (M08.1)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Excludes2
- M35.2 — Behçet's disease[Excludes2]: “Behçet's disease (M35.2)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Excludes1 notes
- G55 — Nerve root and plexus compressions in diseases classified elsewhere[Excludes1]: “nerve root compression (due to) (in) ankylosing spondylitis (M45.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- M05 — Rheumatoid arthritis with rheumatoid factor[Excludes1]: “rheumatoid arthritis of spine (M45.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Excludes2 notes
- M20 — Acquired deformities of fingers and toes[Excludes2]: “joints of the spine (M40-M54)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- M20-M25 — Other joint disorders (M20-M25)[Excludes2]: “joints of the spine (M40-M54)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- M21 — Other acquired deformities of limbs[Excludes2]: “joints of the spine (M40-M54)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- M22 — Disorder of patella[Excludes2]: “joints of the spine (M40-M54)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- M23 — Internal derangement of knee[Excludes2]: “joints of the spine (M40-M54)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- M24 — Other specific joint derangements[Excludes2]: “joints of the spine (M40-M54)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
- M25 — Other joint disorder, not elsewhere classified[Excludes2]: “joints of the spine (M40-M54)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Referenced by Code First instructions
- J99 — Respiratory disorders in diseases classified elsewhere[Code First]: “ankylosing spondylitis (M45.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
Nearest codes (21)
- M45.0 — Ankylosing spondylitis of multiple sites in spine[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M45.1 — Ankylosing spondylitis of occipito-atlanto-axial region[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M45.2 — Ankylosing spondylitis of cervical region[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M45.3 — Ankylosing spondylitis of cervicothoracic region[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M45.4 — Ankylosing spondylitis of thoracic region[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M45.5 — Ankylosing spondylitis of thoracolumbar region[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M45.6 — Ankylosing spondylitis lumbar region[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- M45.7 — Ankylosing spondylitis of lumbosacral region[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 13 more
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Common coding questions
Can M45 be billed directly?
No. M45 (Ankylosing spondylitis) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "M45 — Ankylosing spondylitis." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/m45-ankylosing-spondylitis
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionAnkylosing spondylitis
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to M45 in its code family, with their registry titles.
- M45.0 — Ankylosing spondylitis of multiple sites in spine
- M45.1 — Ankylosing spondylitis of occipito-atlanto-axial region
- M45.2 — Ankylosing spondylitis of cervical region
- M45.3 — Ankylosing spondylitis of cervicothoracic region
- M45.4 — Ankylosing spondylitis of thoracic region
- M45.5 — Ankylosing spondylitis of thoracolumbar region
- M45.6 — Ankylosing spondylitis lumbar region
- M45.7 — Ankylosing spondylitis of lumbosacral region
- M45.8 — Ankylosing spondylitis sacral and sacrococcygeal region
- M45.9 — Ankylosing spondylitis of unspecified sites in spine
- M45.A — Non-radiographic axial spondyloarthritis
- M45.A0 — Non-radiographic axial spondyloarthritis of unspecified sites in spine
- M45.A1 — Non-radiographic axial spondyloarthritis of occipito-atlanto-axial region
- M45.A2 — Non-radiographic axial spondyloarthritis of cervical region
- M45.A3 — Non-radiographic axial spondyloarthritis of cervicothoracic region
- M45.A4 — Non-radiographic axial spondyloarthritis of thoracic region
- M45.A5 — Non-radiographic axial spondyloarthritis of thoracolumbar region
- M45.A6 — Non-radiographic axial spondyloarthritis of lumbar region
- M45.A7 — Non-radiographic axial spondyloarthritis of lumbosacral region
- M45.A8 — Non-radiographic axial spondyloarthritis of sacral and sacrococcygeal region
- M45.AB — Non-radiographic axial spondyloarthritis of multiple sites in spine