Other idiopathic scoliosis, thoracolumbar region

This code signifies an abnormal, sideways curvature of the spine in the thoracolumbar region (the area spanning the lower thoracic and upper lumbar vertebrae) where the underlying cause is unknown. It represents a non-congenital, non-neuromuscular, and non-syndromic spinal deformity.

Apply this code when documentation specifies idiopathic scoliosis affecting the thoracolumbar spine. This diagnosis is typically made after ruling out other known causes of scoliosis, such as congenital anomalies, neuromuscular disorders, or syndromic conditions. Physician documentation should clearly state "idiopathic scoliosis" and specify the "thoracolumbar region."

• Ensure the documentation explicitly states "idiopathic" and specifies the "thoracolumbar region" to support this code.
• Do not use this code if the scoliosis is congenital, neuromuscular, or secondary to another condition; instead, select a more specific code from M41.0- or M41.4-.
• Always review for laterality or severity if documented, though this specific code does not differentiate.