2026 ICD-10-CM Diagnosis Code M49.87Spondylopathy in diseases classified elsewhere, lumbosacral region
ICD-10-CM Codes›M00–M99›M45-M49›M49
- Billable — Valid for Submission
- Not Chronic
M49.87 is a billable ICD-10-CM diagnosis code for spondylopathy in diseases classified elsewhere, lumbosacral region. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 551 through 552. The code is a manifestation code that cannot be reported as the principal diagnosis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Spondylopathies/spondyloarthropathy (including infective).
M49.87 no longer risk-adjusts for Medicare Advantage: it mapped to HCC 40 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 40, ESRD (V21) category 40, and ESRD (V24) category 40 for payment year 2026.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for M49.87.
Medicare Risk Adjustment (HCC)Billing
M49.87 no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.
Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
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:
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert M49.87 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M49.87Overview
What is the ICD-10 code for spondylopathy in diseases classified elsewhere, lumbosacral region?
The ICD-10-CM code for spondylopathy in diseases classified elsewhere, lumbosacral region is M49.87 (sometimes written as M4987). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is M49.87 (Spondylopathy in diseases classified elsewhere) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report spondylopathy in diseases classified elsewhere, lumbosacral region on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does M49.87 group to?
On inpatient claims, spondylopathy in diseases classified elsewhere, lumbosacral region maps to MS-DRG 551, 552, with relative weights from 0.9613 to 1.6761 depending on complications. Higher weights mean higher Medicare reimbursement.
Can M49.87 be a principal diagnosis?
No. This is a manifestation code: spondylopathy in diseases classified elsewhere, lumbosacral region describes the manifestation of an underlying disease rather than the disease itself, so the underlying condition is sequenced first.
What is the ICD-9 equivalent of M49.87?
Under the General Equivalence Mappings, spondylopathy in diseases classified elsewhere, lumbosacral region converts to ICD-9-CM 720.81 (spondylopathy in oth dis). The mapping is approximate, so confirm the match fits the documentation.
Does M49.87 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage. M49.87 mapped to HCC 40 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 40 (Rheumatoid Arthritis and Inflammatory Connective Tissue Disease), ESRD (V21) category 40 (Rheumatoid Arthritis and Inflammatory Connective Tissue Disease), and ESRD (V24) category 40 (Rheumatoid Arthritis and Inflammatory Connective Tissue Disease).
