ICD-10 · PDGM grouping
M43 Other deforming dorsopathies
All 50 codes in the M43 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
ICD-10-CM FY2027 · CMS grouper v07.2.26
Codes in family
50
Can lead a claim
44
Cannot lead a claim
6
What CMS assigns to M43
44 of the 50 codes group to Musculoskeletal Rehabilitation; 6 are assigned no clinical group. None of the 50 is assigned a comorbidity subgroup. 44 of the 50 can lead a claim.
Every code in M43
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| M43.0 Spondylolysis | ||||
| M43.00 | Spondylolysis, site unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M43.01 | Spondylolysis, occipito-atlanto-axial region | Can lead a claim | E | None |
| M43.02 | Spondylolysis, cervical region | Can lead a claim | E | None |
| M43.03 | Spondylolysis, cervicothoracic region | Can lead a claim | E | None |
| M43.04 | Spondylolysis, thoracic region | Can lead a claim | E | None |
| M43.05 | Spondylolysis, thoracolumbar region | Can lead a claim | E | None |
| M43.06 | Spondylolysis, lumbar region | Can lead a claim | E | None |
| M43.07 | Spondylolysis, lumbosacral region | Can lead a claim | E | None |
| M43.08 | Spondylolysis, sacral and sacrococcygeal region | Can lead a claim | E | None |
| M43.09 | Spondylolysis, multiple sites in spine | Can lead a claim | E | None |
| M43.1 Spondylolisthesis | ||||
| M43.10 | Spondylolisthesis, site unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M43.11 | Spondylolisthesis, occipito-atlanto-axial region | Can lead a claim | E | None |
| M43.12 | Spondylolisthesis, cervical region | Can lead a claim | E | None |
| M43.13 | Spondylolisthesis, cervicothoracic region | Can lead a claim | E | None |
| M43.14 | Spondylolisthesis, thoracic region | Can lead a claim | E | None |
| M43.15 | Spondylolisthesis, thoracolumbar region | Can lead a claim | E | None |
| M43.16 | Spondylolisthesis, lumbar region | Can lead a claim | E | None |
| M43.17 | Spondylolisthesis, lumbosacral region | Can lead a claim | E | None |
| M43.18 | Spondylolisthesis, sacral and sacrococcygeal region | Can lead a claim | E | None |
| M43.19 | Spondylolisthesis, multiple sites in spine | Can lead a claim | E | None |
| M43.2 Fusion of spine | ||||
| M43.20 | Fusion of spine, site unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M43.21 | Fusion of spine, occipito-atlanto-axial region | Can lead a claim | E | None |
| M43.22 | Fusion of spine, cervical region | Can lead a claim | E | None |
| M43.23 | Fusion of spine, cervicothoracic region | Can lead a claim | E | None |
| M43.24 | Fusion of spine, thoracic region | Can lead a claim | E | None |
| M43.25 | Fusion of spine, thoracolumbar region | Can lead a claim | E | None |
| M43.26 | Fusion of spine, lumbar region | Can lead a claim | E | None |
| M43.27 | Fusion of spine, lumbosacral region | Can lead a claim | E | None |
| M43.28 | Fusion of spine, sacral and sacrococcygeal region | Can lead a claim | E | None |
| M43.3 | Recurrent atlantoaxial dislocation with myelopathy | Can lead a claim | E | None |
| M43.4 | Other recurrent atlantoaxial dislocation | Can lead a claim | E | None |
| M43.5 Other recurrent vertebral dislocation | ||||
| M43.5X Other recurrent vertebral dislocation | ||||
| M43.5X2 | Other recurrent vertebral dislocation, cervical region | Can lead a claim | E | None |
| M43.5X3 | Other recurrent vertebral dislocation, cervicothoracic regionCMS: Oth recurrent vertebral dislocation, cervicothoracic region | Can lead a claim | E | None |
| M43.5X4 | Other recurrent vertebral dislocation, thoracic region | Can lead a claim | E | None |
| M43.5X5 | Other recurrent vertebral dislocation, thoracolumbar region | Can lead a claim | E | None |
| M43.5X6 | Other recurrent vertebral dislocation, lumbar region | Can lead a claim | E | None |
| M43.5X7 | Other recurrent vertebral dislocation, lumbosacral region | Can lead a claim | E | None |
| M43.5X8 | Other recurrent vertebral dislocation, sacral and sacrococcygeal regionCMS: Oth recurrent vertebral dislocation, sacr/sacrocygl region | Can lead a claim | E | None |
| M43.5X9 | Other recurrent vertebral dislocation, site unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M43.6 | Torticollis | Can lead a claim | E | None |
| M43.8 Other specified deforming dorsopathies | ||||
| M43.8X Other specified deforming dorsopathies | ||||
| M43.8X1 | Other specified deforming dorsopathies, occipito-atlanto-axial regionCMS: Oth deforming dorsopathies, occipito-atlanto-axial region | Can lead a claim | E | None |
| M43.8X2 | Other specified deforming dorsopathies, cervical region | Can lead a claim | E | None |
| M43.8X3 | Other specified deforming dorsopathies, cervicothoracic regionCMS: Oth deforming dorsopathies, cervicothoracic region | Can lead a claim | E | None |
| M43.8X4 | Other specified deforming dorsopathies, thoracic region | Can lead a claim | E | None |
| M43.8X5 | Other specified deforming dorsopathies, thoracolumbar region | Can lead a claim | E | None |
| M43.8X6 | Other specified deforming dorsopathies, lumbar region | Can lead a claim | E | None |
| M43.8X7 | Other specified deforming dorsopathies, lumbosacral region | Can lead a claim | E | None |
| M43.8X8 | Other specified deforming dorsopathies, sacral and sacrococcygeal regionCMS: Oth deforming dorsopathies, sacral and sacrococcygeal region | Can lead a claim | E | None |
| M43.8X9 | Other specified deforming dorsopathies, site unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M43.9 | Deforming dorsopathy, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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