Ankylosing hyperostosis, occipito-atlanto-axial region

This code describes Forestier's disease, also known as diffuse idiopathic skeletal hyperostosis (DISH), specifically affecting the cervical spine at the occiput, atlas, and axis. It is characterized by ossification of ligaments and entheses, leading to bony bridging along the anterior longitudinal ligament. This condition can result in spinal stiffness, pain, and dysphagia due to esophageal compression.

Use this code when documentation confirms a diagnosis of ankylosing hyperostosis (DISH) with specific involvement of the C0-C2 spinal segments. Supporting documentation should include imaging reports (e.g., X-ray, CT scan) detailing the characteristic flowing osteophytes or ossification in this region, along with a physician's diagnostic statement.

• Ensure the documentation explicitly states involvement of the occipito-atlanto-axial region; generalized DISH without this specific localization would use a different code.
• Do not confuse with ankylosing spondylitis (M45.-), which is an inflammatory arthropathy with different diagnostic criteria.
• Code any associated symptoms, such as dysphagia (R13.1x) or cervicalgia (M54.2), as secondary diagnoses.