ICD-10-CM · Spine

M40.14

M40.14 identifies kyphosis of the thoracic spine that is secondary to an underlying condition — not postural in origin and not congenital, postprocedural, or part of a kyphoscoliosis pattern.

Verified May 8, 2026 · 4 sources ↓

Status: Billable
Chapter: 13
Related CPT: 12
Region: Spine

Drawn from CDCICD10DataAAPCIcdcodes

Documentation tips

What should appear in the chart to support M40.14.

Source · Editorial brief grounded in 4 cited references ↓

Identify the underlying causative condition by name (e.g., osteoporosis, neuromuscular disease, prior infection) — this is required by the 'Code First' instruction and determines sequencing.
Record Cobb angle from standing AP and lateral spine radiographs; note the apex vertebral level and whether the curve is rigid or flexible.
Specify thoracic region explicitly in the assessment — if the curve extends to the thoracolumbar junction (T12–L1), use M40.15 instead.
Document any neurological findings, functional deficits, or pain referral pattern that support medical necessity for imaging, orthosis, or surgical consultation.
When osteoporosis is the driver, code the osteoporosis with current or historical vertebral fracture before M40.14 to satisfy the sequencing rule.

Related CPT procedures

Procedure codes commonly billed with M40.14. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

22800 $1,312.99

Posterior spinal arthrodesis for deformity correction spanning up to 6 vertebral segments, with or without application of a body cast.

22802 $1,936.25

Posterior spinal arthrodesis for deformity correction spanning 7 to 12 vertebral segments, with or without body cast application.

22804 $2,222.50

Posterior spinal arthrodesis for deformity correction spanning 13 or more vertebral segments, performed with or without application of a body cast.

22830 $791.60

Surgical exploration of a previously performed spinal fusion to assess the integrity of the bone graft, instrumentation, and fusion site.

72070 $33.07

Two-view radiologic examination of the thoracic spine, including AP and lateral projections of the 12 thoracic vertebrae.

72072 $38.75

Radiographs of the thoracic spine with three views, typically a frontal, a lateral, and one added projection such as a swimmer's view.

72074 $44.09

Thoracic spine radiographs with at least four views, adding obliques or other projections to the standard frontal and lateral images.

72080 $35.07

Radiologic examination of the thoracolumbar junction (where the thoracic and lumbar spine meet), requiring a minimum of two views.

77080 $39.41

Dual-energy X-ray absorptiometry measurement of bone mineral density at axial sites such as the hips, pelvis, or lumbar spine.

99213 $95.19

Established patient office or outpatient visit requiring 20–29 minutes of total time or low-complexity medical decision-making.

99214 $135.61

Office visit for an established patient requiring moderate-complexity medical decision making (MDM), or 30–39 minutes of total provider time on the date of service.

99215 $192.39

Highest-level office or outpatient E/M visit for an established patient, qualifying via high-complexity medical decision making or 40–54 minutes of total provider time on the date of service.

Common coding pitfalls

The recurring mistakes coders make with M40.14 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

Sequencing M40.14 first when a 'Code First underlying disease' instruction is present — the causative diagnosis must lead the claim.
Using M40.14 for congenital thoracic kyphosis; that maps to Q76.4, which is an Excludes1 condition at the M40 category level.
Applying M40.14 when postprocedural kyphosis (M96.-) is the correct type — surgical or radiation-induced deformity belongs in the M96 category, not M40.
Selecting M40.14 when kyphosis co-exists with scoliosis; combined curves code to kyphoscoliosis (M41.-), another Excludes1 exclusion.
Using M40.04 (postural kyphosis, thoracic) when the chart clearly documents a structural secondary cause — postural and secondary kyphosis have distinct etiologies and different treatment implications.

Clinical context

Source · Editorial summary grounded in 4 cited references ↓

Use M40.14 when thoracic kyphosis arises as a consequence of another pathological process — common drivers include osteoporotic vertebral compression fractures, neuromuscular disease, metabolic bone disease, infection (e.g., Pott disease), or prior radiation therapy affecting the thoracic spine. The 'other secondary' designation distinguishes this code from postural kyphosis (M40.04) and from unspecified or postprocedural kyphosis. Because M40 carries a 'Code First underlying disease' instruction, M40.14 must be sequenced after the code for the causative condition — for example, osteoporosis with vertebral fracture (M80.x) or ankylosing spondylitis (M45.x).

M40.14 is restricted to the thoracic region (roughly T1–T12). If the curve spans the thoracolumbar junction or is documented as thoracolumbar, M40.15 applies instead. Congenital kyphosis (Q76.4), kyphoscoliosis (M41.-), and postprocedural kyphosis (M96.-) are all Excludes1 conditions at the M40 category level — do not combine those codes with M40.14.

Clinical documentation should establish both the thoracic location and the secondary etiology. A Cobb angle measurement from upright spine radiographs, MRI, or CT supports medical necessity and distinguishes a pathological curve from normal thoracic kyphosis. Document the underlying condition explicitly in the same encounter note so code sequencing is unambiguous.

Sibling codes

Other billable codes under M40.1 (laterality / anatomic variants).

M40.12

Other secondary kyphosis, cervical region

M40.15

Other secondary kyphosis, thoracolumbar region

M40.10

Other secondary kyphosis, site unspecified

M40.13

Other secondary kyphosis, cervicothoracic region

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 4 cited references ↓

01What conditions most commonly cause secondary thoracic kyphosis coded to M40.14?

Osteoporotic vertebral compression fractures, neuromuscular disorders (e.g., muscular dystrophy, cerebral palsy), metabolic bone disease, spinal tuberculosis (Pott disease), and prior radiation therapy to the thoracic spine are the most frequently documented underlying causes.

02Does M40.14 require a 'Code First' sequencing rule?

Yes. The M40 category carries a 'Code First underlying disease' annotation. The causative condition — osteoporosis, infection, neuromuscular disease, etc. — must be sequenced before M40.14 on the claim.

03What is the difference between M40.14 and M40.04?

M40.04 is postural kyphosis of the thoracic region — a non-structural, posture-related curve without an identifiable pathological cause. M40.14 is structurally driven by an underlying disease process. The etiologic distinction must be documented by the provider; do not default to postural coding when a secondary cause is identified.

04Can M40.14 be used when the patient also has scoliosis in the thoracic spine?

No. When kyphosis co-exists with scoliosis, the correct code is from the kyphoscoliosis category M41.-. M41 is listed as an Excludes1 condition at the M40 category level, meaning M40.14 and M41.- cannot be coded together for the same spinal region.

05What imaging documentation best supports M40.14?

Standing AP and lateral thoracic spine radiographs with a Cobb angle measurement are the standard. Document the apex vertebral level, degree of curvature, any vertebral body collapse or wedging, and correlation with the underlying condition. MRI or CT adds specificity when infection, malignancy, or neurological compromise is present.

06When should M40.15 be used instead of M40.14?

Use M40.15 (other secondary kyphosis, thoracolumbar region) when the apex or primary deformity involves the T12–L1 junction rather than being isolated to the mid or upper thoracic spine. Region designation should follow the provider's documented anatomical description or the apex level identified on imaging.

07Is M40.14 appropriate for postprocedural thoracic kyphosis after spinal surgery?

No. Postprocedural kyphosis and lordosis are classified under M96.- codes, which are Excludes1 at the M40 level. If the deformity developed as a direct complication of a prior spinal procedure, use the applicable M96 code rather than M40.14.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

01CDC ICD-10-CM Tabular List 2026 (effective October 1, 2025)
02
icd10data.com
https://www.icd10data.com/ICD10CM/Codes/M00-M99/M40-M43/M40-/M40.14
03
aapc.com
https://www.aapc.com/codes/icd-10-codes/M40.14
04
icdcodes.ai
https://icdcodes.ai/diagnosis/thoracic-kyphosis/documentation

Mira Scribe

Mira's AI scribe captures the thoracic region designation, documented underlying condition (e.g., osteoporosis, neuromuscular disease), Cobb angle from imaging, and any neurological or functional findings from the encounter. This ensures M40.14 is sequenced after its causative diagnosis code rather than listed first — preventing a sequencing error that triggers claim rejection or audit scrutiny under the ICD-10-CM 'Code First' instruction.

See how Mira captures M40.14 documentation