ICD-10-CM · Spine

M47.24

Degenerative spinal disease of the thoracic vertebrae (T1–T12) that produces nerve root compression or irritation, resulting in thoracic radiculopathy — often presenting as band-like chest wall or trunk pain radiating along the dermatomal path of the affected thoracic nerve root.

Verified May 8, 2026 · 5 sources ↓

Status
Billable
Chapter
13
Related CPT
16
Region
Spine
Drawn from CDCICD10DataOutsourcestrategiesIcdcodesCMS

Documentation tips

What should appear in the chart to support M47.24.

Source · Editorial brief grounded in 5 cited references ↓

  • Explicitly state 'thoracic radiculopathy secondary to spondylosis' or equivalent — don't leave the causal link implicit.
  • Identify the affected thoracic level(s) (e.g., T6–T7) in the note and correlate to imaging findings such as foraminal stenosis or disc-osteophyte complex.
  • Record the dermatomal distribution of pain or sensory symptoms (e.g., band-like pain wrapping around the chest wall at the T8 level).
  • Document provocative and relieving factors, as well as any motor or reflex deficits that confirm nerve root involvement.
  • Note prior conservative treatment (physical therapy, NSAIDs, steroid taper) to support medical necessity for interventional procedures billed alongside this code.
  • If MRI or CT myelogram was performed, include the radiologist's conclusion in the clinical impression — reference the specific level showing nerve root compromise.

Related CPT procedures

Procedure codes commonly billed with M47.24. Linking the right diagnosis to the right procedure is what establishes medical necessity.

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

62321 $276.56
Cervical or thoracic interlaminar epidural or subarachnoid injection of a drug such as a steroid, done with fluoroscopic or CT imaging guidance.
64490 $205.08
Injection of anesthetic or steroid into a cervical or thoracic facet joint, or at the medial branch nerves supplying it, at a single level with imaging guidance.
64491 $101.87
Add-on for a second cervical or thoracic facet joint or medial branch level injected during the same session, with imaging guidance included.
64492 $102.21
Add-on for a third or later cervical or thoracic facet joint or medial branch level injected in one session, with imaging guidance included.
64493 $190.39
Injection of anesthetic or steroid into a lumbar or sacral facet joint, or at the medial branch nerves supplying it, at one level with imaging guidance.
64494 $95.86
Add-on for a second lumbar or sacral facet joint or medial branch level injected during the same session, with imaging guidance included.
64495 $98.87
Add-on for a third or later lumbar or sacral facet joint or medial branch level injected in one session, with imaging guidance included.
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.
72141 $190.72
MRI of the cervical spinal canal and its contents performed without contrast material.
72142 $273.89
Magnetic resonance imaging of the cervical spine performed only after a contrast agent is given, without a separate non-contrast sequence set.
72157 $318.64
Thoracic spine MRI performed first without contrast and then repeated after contrast during one imaging session.
63056 $1,404.84
Lumbar spinal cord and nerve root decompression via transpedicular approach, single segment, including transfacet or lateral extraforaminal variants for far lateral disc herniations.
63057 $287.58
Add-on code for transpedicular spinal cord/nerve root decompression at each additional thoracic or lumbar segment beyond the primary procedure.
22532 $1,732.17
Spinal fusion at a single thoracic vertebral segment using the lateral extracavitary approach, which provides a wide posterolateral corridor to the anterior and middle columns without entering the thoracic cavity. Includes minimal discectomy to prepare the interspace for fusion.
22533 $1,547.80
Spinal fusion of a lumbar vertebral segment performed through a lateral extracavitary approach, including minimal discectomy to prepare the interspace (not performed solely for decompression).

Common coding pitfalls

The recurring mistakes coders make with M47.24 and adjacent codes.

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

  • Using M47.24 when only axial thoracic back pain is documented — without radiculopathy, the correct code is M47.814.
  • Confusing radiculopathy with myelopathy: cord compression signs (spasticity, hyperreflexia, gait disturbance) point to M47.14, not M47.24.
  • Dropping to M47.20 (site unspecified) when the thoracic region is clearly documented — always code to the highest level of specificity available.
  • Billing M47.24 alongside a lumbar or cervical nerve block CPT code without verifying the procedure site matches the thoracic diagnosis — payers cross-check anatomical consistency.
  • Failing to distinguish thoracic from thoracolumbar involvement: if the junction (T12–L1) is the primary site, consider M47.25 instead.

Clinical context

Source · Editorial summary grounded in 5 cited references ↓

M47.24 applies when thoracic spondylosis — degenerative changes including disc space narrowing, facet joint arthrosis, osteophyte formation, or ligamentous hypertrophy — is the direct cause of radiculopathy at the thoracic level. The provider must explicitly link the nerve root symptoms to spondylotic pathology; imaging alone is insufficient without clinical correlation documenting radicular signs.

Thoracic radiculopathy is far less common than cervical or lumbar radiculopathy, so payers may scrutinize the diagnosis. Supportive documentation should include dermatomal pain distribution, positive provocative testing, and imaging findings (MRI or CT myelogram) demonstrating nerve root compression at the implicated thoracic level. If the record documents only axial thoracic pain without radiculopathy, use M47.814 (spondylosis without myelopathy or radiculopathy, thoracic region) instead.

Do not use M47.24 when the dominant finding is myelopathy rather than radiculopathy — thoracic spondylosis with myelopathy belongs under M47.14. If both are present, query the provider on the primary neurological manifestation or code both if supported. M47.24 maps to MS-DRG v43.0 groups 551 (medical back problems with MCC) and 552 (without MCC).

Sibling codes

Other billable codes under M47.2 (laterality / anatomic variants).

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What distinguishes M47.24 from M47.814?
M47.814 is spondylosis without myelopathy or radiculopathy in the thoracic region — use it for purely axial pain. M47.24 requires documented radiculopathy (dermatomal pain, sensory change, or motor deficit) causally linked to thoracic spondylosis.
02When should I use M47.14 instead of M47.24?
M47.14 codes thoracic spondylosis with myelopathy — cord compression signs such as spasticity, hyperreflexia, and gait disturbance. If the provider documents both myelopathy and radiculopathy, query for the primary diagnosis or assign both if the record supports it.
03Is imaging required to bill M47.24?
Imaging is not a strict billing requirement, but it is practically essential. Without MRI or CT myelogram demonstrating nerve root compression at a thoracic level, payers will frequently deny or audit claims for thoracic radiculopathy due to the rarity of this presentation.
04Can M47.24 be used as the primary diagnosis for a thoracic epidural steroid injection (CPT 62321)?
Yes — M47.24 is an accepted primary diagnosis for thoracic interlaminar epidural steroid injection (CPT 62321) when documentation confirms thoracic radiculopathy caused by spondylosis. Ensure the injection level corresponds to the documented thoracic segment.
05What if the radiculopathy spans the thoracolumbar junction?
If the spondylosis and nerve root involvement are centered at the thoracolumbar junction (T12–L1), use M47.25 (other spondylosis with radiculopathy, thoracolumbar region) instead of M47.24.
06Does M47.24 require a 7th-character extension?
No. M47.24 is an M-code and does not use 7th-character extensions. It is complete as a 5-character code and is billable as listed.
07Which MS-DRG groups does M47.24 map to?
Under MS-DRG v43.0, M47.24 maps to DRG 551 (medical back problems with MCC) or DRG 552 (medical back problems without MCC), depending on the presence of a major complicating condition.

Mira Scribe

Mira's AI scribe captures the thoracic dermatomal pain distribution, specific vertebral levels on imaging, nerve root compression findings (foraminal stenosis, disc-osteophyte complex), and any motor or sensory deficits documented during the encounter. This prevents downcoding to unspecified spondylosis (M47.20) or the non-radiculopathy variant (M47.814), both of which can trigger payer requests for additional documentation or result in reduced reimbursement.

See how Mira captures M47.24 documentation

Related ICD-10 codes

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