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ICD-10-CM 2027 diagnosis code

M43.06Spondylolysis, lumbar region

✓ Billable / specific

M43.06 is a valid, billable ICD-10-CM code for spondylolysis, lumbar region. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.

Code unchanged since ICD-10-CM took effect on October 1, 2015. Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data

About M43.06

M43.06 is the ICD-10-CM diagnosis code for Spondylolysis, lumbar region. It belongs to category M43 (other deforming dorsopathies), block M40-M43 (deforming dorsopathies) and chapter 13 (diseases of the musculoskeletal system and connective tissue). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within M43.0 (Spondylolysis), M43.06 is specifically for Spondylolysis, lumbar region. Related codes cover site unspecified (M43.00), occipito-atlanto-axial region (M43.01), cervical region (M43.02), cervicothoracic region (M43.03), thoracic region (M43.04), thoracolumbar region (M43.05), lumbosacral region (M43.07), sacral and sacrococcygeal region (M43.08) and 1 more.

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 551 (Medical Back Problems with MCC, relative weight 1.6358) and DRG 552 (Medical Back Problems without MCC, relative weight 0.9584), in MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as 738.4 (acquired spondylolisthesis).

Notes that apply from higher levels

Instructions written at a parent level also apply to M43.06.

› From M43.0 Spondylolysis
Excludes1
  • congenital spondylolysis (Q76.2)
  • spondylolisthesis (M43.1)
› From M43 Other deforming dorsopathies
Excludes1
  • congenital spondylolysis and spondylolisthesis (Q76.2)
  • hemivertebra (Q76.3-Q76.4)
  • Klippel-Feil syndrome (Q76.1)
  • lumbarization and sacralization (Q76.4)
  • platyspondylisis (Q76.4)
  • spina bifida occulta (Q76.0)
  • spinal curvature in osteoporosis (M80.-)
  • spinal curvature in Paget's disease of bone [osteitis deformans] (M88.-)

Broader instructions also apply from Chapter 13: Diseases of the musculoskeletal system and connective tissue.

Alphabetic index entries

1 entries

Terms in the official ICD-10-CM index that lead to M43.06.

MS-DRG v44.0 grouping

All DRGs →

Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.

MDC 08 · Diseases and Disorders of the Musculoskeletal System and Connective Tissue

ICD-9-CM equivalent

Converter →
  • 738.4Acquired spondylolisthesisapproximate

From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.

Code history

  1. 2016
  2. 2017
  3. 2018
  4. 2019
  5. 2020
  6. 2021
  7. 2022
  8. 2023
  9. 2024
  10. 2025
  11. 2026
  12. 2027
  • FY2016 (effective 10/1/2015): Added (first year of ICD-10-CM)
  • No changes since FY2016.

Common questions about M43.06

Is M43.06 billable?

Yes. M43.06 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).

Can M43.06 be used as a principal diagnosis?

Yes. The Medicare Code Editor doesn't restrict M43.06 as a principal diagnosis.

Is M43.06 a CC or MCC?

No. M43.06 is neither a CC nor an MCC under MS-DRG v44.0.

What DRG does M43.06 group to?

M43.06 is used in the MS-DRG v44.0 logic for MS-DRG 551 (Medical Back Problems with MCC) and MS-DRG 552 (Medical Back Problems without MCC). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.

What is the ICD-9 code for M43.06?

The CMS General Equivalence Mappings map M43.06 to ICD-9-CM 738.4.