M48.00: Spinal stenosis, site unspecified

The ICD-10-CM code for spinal stenosis when the provider diagnoses narrowing of the spinal canal without naming the region of the spine where it sits.

Billable

FY2027

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At a glance

Code Family

M48.0: Spinal stenosis

DRG Grouping

MS-DRG 551 or 552, Medical back problems, when M48.00 is the principal diagnosis under the FY2027 MS-DRG v44 grouper.

HCC Mapping (v28)

None. M48.00 does not map to a payment HCC in the CMS-HCC v28 diagnosis crosswalk.

Family Specificity

Ten billable codes sit in the M48.0 subcategory, including M48.00. M48.00 is the only one that names no spinal region.

Billable

Yes. M48.00 is a complete five-character code in the FY2027 billable code list.

Effective Date

Valid in the FY2026 code set and unchanged in the FY2027 update.

Which M48.0 code do I assign?

Subcategory M48.0 splits spinal stenosis by the region of the spine the provider names, from the occipito-atlanto-axial level down to the sacral and sacrococcygeal level. Only the lumbar region takes a sixth character, which records whether neurogenic claudication is documented.

When documentation says…

Code

Spinal stenosis, region not stated

M48.00

Spinal stenosis, site unspecified. The Index sends Stenosis, spinal with no region subterm here. Query the provider when the record points to a level the diagnosis does not state.

Cervical spinal stenosis

M48.02

Spinal stenosis, cervical region. The Index sends Stenosis, spinal, cervical region here. Stenosis documented at the cervicothoracic junction goes to M48.03 instead.

Thoracic spinal stenosis

M48.04

Spinal stenosis, thoracic region. The Index sends Stenosis, spinal, thoracic region here. Stenosis documented at the thoracolumbar junction goes to M48.05 instead.

Lumbar spinal stenosis

M48.061

Spinal stenosis, lumbar region without neurogenic claudication. The Index sends lumbar region stenosis NOS here. The note names the lumbar spine and records no neurogenic claudication.

Lumbar stenosis with neurogenic claudication

M48.062

Spinal stenosis, lumbar region with neurogenic claudication. The provider documents neurogenic claudication with the lumbar stenosis. Claudication with no qualifier indexes to I73.9. Query the provider when the type is not stated.

Lumbosacral spinal stenosis

M48.07

Spinal stenosis, lumbosacral region. The Index sends Stenosis, spinal, lumbosacral region here. This code takes no sixth character and has no claudication axis.

Caudal or sacrococcygeal stenosis

M48.08

Spinal stenosis, sacral and sacrococcygeal region. The Index sends Stenosis, caudal and Stenosis, spinal, sacrococcygeal region here. Caudal stenosis is also an inclusion term at M48.0.

Tabular notes

INCLUSION TERMS

M48.00 carries no inclusion term of its own.

Subcategory M48.0 carries one inclusion term: caudal stenosis. The Index sends Stenosis, caudal to M48.08 rather than to M48.00.

EXCLUDES1

M48.00, subcategory M48.0, category M48 and block M45-M49 carry no Excludes1 note.

Category G55 carries an Excludes1 note for nerve root compression (due to) (in) spondylopathies (the M46 and M48 codes). G55 is not added for nerve root compression caused by the stenosis.

An Excludes1 pair is not reported together for the same condition. Guideline I.A.12.a allows both codes when the two conditions are unrelated.

EXCLUDES2

M48.00 and every level above it to block M45-M49 carry no Excludes2 note of their own.

Chapter 13 carries an Excludes2 note listing, among others, certain infectious and parasitic diseases (A00-B99), neoplasms (C00-D49) and injury, poisoning and certain other consequences of external causes (S00-T88).

An Excludes2 note means the excluded condition is not part of the code above it. Both are coded when the patient has both.

USE ADDITIONAL

M48.00, M48.0, M48 and block M45-M49 carry no use additional code instruction. None of them carries a code first or code also instruction.

Chapter 13 instructs the coder to use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause.

FY2027: EFFECTIVE 1 OCTOBER 2026

The FY2027 codes addenda list no addition, deletion or revision for M48.00 or for any other code in category M48.

M48.00 is in the FY2027 billable code list with the same descriptor it carried in FY2026.

Operational & financial impact

Why specificity matters beyond the chart: risk adjustment, DRG assignment and denial exposure all follow from which code is selected.

CMS-HCC v28 (PY2024+)

No code in subcategory M48.0 maps to a payment HCC in the CMS-HCC v28 diagnosis crosswalk in the model software files.

A region code in place of M48.00 does not change the HCC mapping.

M47.812, M47.816, M54.12, M54.16 and the lumbar M99 stenosis codes map to no payment HCC in the same crosswalk.

MS-DRG v44 (FY2027)

MS-DRG 551: Medical back problems with MCC.

MS-DRG 552: Medical back problems without MCC.

M48.00 as principal diagnosis groups to one of these two DRGs in MDC 08, per the CMS MS-DRG v44.0 Definitions Manual, Appendix B.

M48.061 groups to the same two DRGs as principal diagnosis.

Medicare and commercial payers

Coverage of spinal imaging, epidural steroid injections and decompression surgery is set by payer policy and by MAC local coverage determinations.

Those policies read the diagnosis on the claim. M48.00 reports spinal stenosis with no level attached.

WHERE SPECIFICITY IS LOST

Reporting M48.00 when the provider names a region discards that region. Section IV.F.3 calls for coding to the highest level of specificity supported by the medical record documentation.

Reporting M48.00 for lumbar stenosis with neurogenic claudication drops the claudication that M48.062 carries.

Reporting M48.00 for foraminal or neural canal stenosis described by tissue type replaces the M99 code the Index assigns to those terms.

SEVERITY DESIGNATION (MS-DRG V44, FY2027)

M48.00 is on neither list. It carries no CC or MCC designation as a secondary diagnosis.

No code in subcategory M48.0 carries a CC or MCC designation.

Per Table 6I (Complete MCC List) and Table 6J (Complete CC List) of the FY2027 IPPS final rule (CMS-1849-F), MS-DRG v44.

Documentation checklist to support M48.00

Chart elements that support code selection and reduce specificity-driven denials.

The region of the spine the provider names for the stenosis. Each documented region indexes to its own M48.0 code.

Every region involved when the stenosis spans more than one level. Guideline I.C.13.a.2 assigns codes for specified sites individually by site when documented.

Whether neurogenic claudication is documented with lumbar stenosis. Its presence moves the code to M48.062.

Claudication recorded without the word neurogenic. The Index sends Claudication (intermittent) with no qualifier to I73.9.

Whether the narrowing is called spinal stenosis or is described as foraminal or neural canal stenosis by tissue type. The latter terms index to M99 codes.

Radiculopathy, myelopathy or spondylosis named as a separate diagnosis, with its region.

Any current, acute spinal injury, which Guideline I.C.13.b sends to the injury codes in Chapter 19.

For outpatient encounters, a confirmed diagnosis only. Stenosis documented as probable or suspected is not coded (Section IV.H).

FAQ

Is M48.00 a billable code?

Yes. M48.00 is a complete five-character code in the FY2027 billable code list. It takes no further characters. Its parent M48.0 is a subcategory header and cannot be reported.

What is the ICD-10 code for spinal stenosis?

M48.00 when the provider names no region. The Index sends Stenosis, spinal to M48.00 and lists a subterm for each region. Cervical stenosis goes to M48.02, thoracic to M48.04 and lumbosacral to M48.07. Lumbar stenosis goes to M48.061, or to M48.062 with neurogenic claudication.

When is M48.00 the right code instead of a region code?

Only when the record does not document the region after review. Guideline I.B.18 accepts an unspecified code when it most accurately reflects what is known at that encounter. Guideline I.B.2 calls for the highest level of specificity documented in the medical record. Query the provider when the level is discussed but not stated in the diagnosis.

Does M48.00 map to an HCC?

No. M48.00 does not map to a payment HCC in the CMS-HCC v28 diagnosis crosswalk. None of the region codes in subcategory M48.0 maps to one either.

How is stenosis at more than one spinal region coded?

Code each documented region. Subcategory M48.0 has no multiple sites code. Guideline I.C.13.a.2 states that codes describing specified sites are assigned individually by site when documented. Cervical and lumbar stenosis without neurogenic claudication take M48.02 and M48.061.

How is foraminal or neural canal stenosis coded?

By the term and tissue type the provider documents. The Index sends Stenosis, intervertebral foramina and Stenosis, neural canal to M99 codes by tissue type and region. Lumbar foraminal stenosis from disc or connective tissue goes to M99.73. Osseous lumbar foraminal stenosis goes to M99.63. Category M99 carries a note that it should not be used if the condition can be classified elsewhere.

Can neurogenic claudication be captured when no region is documented?

No. The claudication axis exists only at subcategory M48.06, the lumbar region. Under Stenosis, spinal, the Index lists neurogenic claudication only below the lumbar region subterm. Query the provider for the region when neurogenic claudication is documented with stenosis of no stated level.

How is M48.00 sequenced, and did it change in FY2027?

M48.00 is listed first when the stenosis is chiefly responsible for the encounter (Section IV.G). Guideline I.C.6.b.1 names spinal stenosis as the principal diagnosis when an admission is for a procedure treating it, with no G89 code. Inpatient uncertain diagnoses are coded as established (Section II.H). M48.00 is unchanged in the FY2027 codes addenda.

Related codes

Codes in the same family as M48.00. Only codes with a published page render as links.

Sibling codes in the M48.0 family

M48.01: Spinal stenosis, occipito-atlanto-axial region.
M48.02: Spinal stenosis, cervical region.
M48.03: Spinal stenosis, cervicothoracic region.
M48.04: Spinal stenosis, thoracic region.
M48.05: Spinal stenosis, thoracolumbar region.
M48.061: Spinal stenosis, lumbar region without neurogenic claudication, which also covers lumbar spinal stenosis NOS.
M48.062: Spinal stenosis, lumbar region with neurogenic claudication.
M48.07: Spinal stenosis, lumbosacral region.
M48.08: Spinal stenosis, sacral and sacrococcygeal region, which the Index also assigns to caudal stenosis.

Additional codes to consider

Codes outside the M48.0 family considered alongside M48.00.

Consider instead

M99.73: Connective tissue and disc stenosis of intervertebral foramina of lumbar region, when lumbar foraminal stenosis from disc or connective tissue is documented.
M99.63: Osseous and subluxation stenosis of intervertebral foramina of lumbar region, when osseous lumbar foraminal stenosis is documented.
M99.71: Connective tissue and disc stenosis of intervertebral foramina of cervical region, when cervical foraminal stenosis from disc or connective tissue is documented.
M47.816: Spondylosis without myelopathy or radiculopathy, lumbar region, when the provider documents lumbar spondylosis and not spinal stenosis.
M47.812: Spondylosis without myelopathy or radiculopathy, cervical region, when the provider documents cervical spondylosis and not spinal stenosis.
M54.16: Radiculopathy, lumbar region, when the provider documents lumbar radiculopathy and not spinal stenosis.
M54.12: Radiculopathy, cervical region, when the provider documents cervical radiculopathy and not spinal stenosis.
I73.9: Peripheral vascular disease, unspecified, when the provider documents intermittent claudication with no neurogenic or spinal cord qualifier.

Sources

All claims on this page derive from government and professional-standards sources.

National Center for Health Statistics. (2026). International classification of diseases, tenth revision, clinical modification (ICD-10-CM) FY2027 files. https://www.cdc.gov/nchs/icd/icd-10-cm/files.html
Centers for Medicare & Medicaid Services and National Center for Health Statistics. (2026). ICD-10-CM official guidelines for coding and reporting FY2027. https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD10CM/2027/ICD-10-CM-October-1-2026-FY27-Guidelines.pdf
Centers for Medicare & Medicaid Services. (2025). 2026 model software/ICD-10 mappings. https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/risk-adjustment/2026-model-software-icd-10-mappings
Centers for Medicare & Medicaid Services. (2026). MS-DRG classifications and software, version 44. https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/ms-drg-classifications-and-software