ICD-10 Code M42.11

Adult osteochondrosis of spine, occipito-atlanto-axial region

Version 2019 Billable Code Adult Diagnoses
ICD-10: M42.11
Short Description:Adult osteochondrosis of spine, occipt-atlan-ax region
Long Description:Adult osteochondrosis of spine, occipito-atlanto-axial region

Valid for Submission

ICD-10 M42.11 is a billable code used to specify a medical diagnosis of adult osteochondrosis of spine, occipito-atlanto-axial region. The code is valid for the year 2019 for the submission of HIPAA-covered transactions.

Code Classification

  • Diseases of the musculoskeletal system and connective tissue (M00–M99)
    • Deforming dorsopathies (M40-M43)
      • Spinal osteochondrosis (M42)

Information for Medical Professionals

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

  • Adult diagnoses - Adult. Age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).

Diagnostic Related Groups

The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). The diagnosis code M42.11 is grouped in the following groups for version MS-DRG V36.0 applicable from 10/01/2018 through 09/30/2019.

  • 553 - BONE DISEASES AND ARTHROPATHIES WITH MCC
  • 554 - BONE DISEASES AND ARTHROPATHIES WITHOUT MCC

Convert M42.11 to ICD-9

The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:

  • 732.8 - Osteochondropathy NEC (Approximate Flag)

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code M42.11 are found in the index:


Information for Patients


Spine Injuries and Disorders

Your backbone, or spine, is made up of 26 bone discs called vertebrae. The vertebrae protect your spinal cord and allow you to stand and bend. A number of problems can change the structure of the spine or damage the vertebrae and surrounding tissue. They include

  • Infections
  • Injuries
  • Tumors
  • Conditions, such as ankylosing spondylitis and scoliosis
  • Bone changes that come with age, such as spinal stenosis and herniated disks

Spinal diseases often cause pain when bone changes put pressure on the spinal cord or nerves. They can also limit movement. Treatments differ by disease, but sometimes they include back braces and surgery.

  • Compression fractures of the back (Medical Encyclopedia)
  • Foraminotomy (Medical Encyclopedia)
  • Kyphosis (Medical Encyclopedia)
  • Laminectomy (Medical Encyclopedia)
  • Lordosis (Medical Encyclopedia)
  • Spinal fusion (Medical Encyclopedia)
  • Spine surgery - discharge (Medical Encyclopedia)
  • Spondylolisthesis (Medical Encyclopedia)

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ICD-10 Footnotes

General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.