M40.204: Unspecified kyphosis, thoracic region
M40.204, unspecified kyphosis, thoracic region, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 8 HCPCS Level II codes, including G0453 (Continuous intraoperative neurophysiology monitoring, from…), G0283 (Electrical stimulation (unattended), to one or more areas…), G0152 (Services performed by a qualified occupational therapist…). The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with M40.204 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0453 | Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure) | Carrier judgment | — | 2 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 2 |
| G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0158 | Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0160 | Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G2169 | Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 1 |
Medicare policy articles listing M40.204
- A57604: Billing and Coding: Intraoperative Neurophysiological Testing (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34623, L35003
- A56722: Billing and Coding: Intraoperative Neurophysiological Testing (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34623, L35003
- A53057: Billing and Coding: Home Health Occupational Therapy (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34560
- A53064: Billing and Coding: Outpatient Occupational Therapy (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34427
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other M40 diagnoses (Kyphosis and lordosis)
- M40.202 — Unspecified kyphosis, cervical region
- M40.203 — Unspecified kyphosis, cervicothoracic region
- M40.205 — Unspecified kyphosis, thoracolumbar region
- M40.292 — Other kyphosis, cervical region
- M40.293 — Other kyphosis, cervicothoracic region
- M40.294 — Other kyphosis, thoracic region
- M40.295 — Other kyphosis, thoracolumbar region
- M40.03 — Postural kyphosis, cervicothoracic region
- M40.04 — Postural kyphosis, thoracic region
- M40.05 — Postural kyphosis, thoracolumbar region
- M40.12 — Other secondary kyphosis, cervical region
- M40.13 — Other secondary kyphosis, cervicothoracic region
- M40.14 — Other secondary kyphosis, thoracic region
- M40.15 — Other secondary kyphosis, thoracolumbar region
- M40.35 — Flatback syndrome, thoracolumbar region
- M40.36 — Flatback syndrome, lumbar region
- M40.37 — Flatback syndrome, lumbosacral region
- M40.45 — Postural lordosis, thoracolumbar region
- M40.46 — Postural lordosis, lumbar region
- M40.47 — Postural lordosis, lumbosacral region
- M40.55 — Lordosis, unspecified, thoracolumbar region
- M40.56 — Lordosis, unspecified, lumbar region
- M40.57 — Lordosis, unspecified, lumbosacral region
Frequently asked questions
Does Medicare cover M40.204 (Unspecified kyphosis, thoracic region)?
Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list M40.204 as a covered diagnosis for 8 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 M40.204?
The Level II codes from the policies most specific to this diagnosis are G0453 (Continuous intraoperative neurophysiology monitoring, from…, 2 articles); G0283 (Electrical stimulation (unattended), to one or more areas…, 2 articles); G0152 (Services performed by a qualified occupational therapist…, 1 article); G0158 (Services performed by a qualified occupational therapist…, 1 article); G0160 (Services performed by a qualified occupational therapist…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list M40.204?
A57604 (Billing and Coding: Intraoperative Neurophysiological Testing); A56722 (Billing and Coding: Intraoperative Neurophysiological Testing); A53057 (Billing and Coding: Home Health Occupational Therapy), and 1 more article.
What is ICD-10-CM code M40.204?
M40.204 is the ICD-10-CM code for unspecified kyphosis, thoracic region, in category M40 (Kyphosis and lordosis), chapter 13: Diseases of the musculoskeletal system and connective tissue.
Next steps
- Run a reimbursement report for a device billed under G0453
- Watch G0453 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0453
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 13: Diseases of the musculoskeletal system and connective tissue · All diagnoses · HCPCS lookup