M41.116: Juvenile idiopathic scoliosis, lumbar region
M41.116, juvenile idiopathic scoliosis, lumbar region, is listed as a covered diagnosis in 5 Medicare billing and coding articles that apply to 10 HCPCS Level II codes, including G0453 (Continuous intraoperative neurophysiology monitoring, from…), G0283 (Electrical stimulation (unattended), to one or more areas…), A9585 (Injection, gadobutrol, 0.1 ml). The articles come from 4 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 M41.116 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 |
| A9585 | Injection, gadobutrol, 0.1 ml | Carrier judgment | — | 1 |
| Q9953 | Injection, iron-based magnetic resonance contrast agent, per ml | Special coverage instructions apply | — | 1 |
| 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 M41.116
- 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
- A57206: Billing and Coding: Lumbar MRI (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L34220
- 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 M41 diagnoses (Scoliosis)
- M41.112 — Juvenile idiopathic scoliosis, cervical region
- M41.113 — Juvenile idiopathic scoliosis, cervicothoracic region
- M41.114 — Juvenile idiopathic scoliosis, thoracic region
- M41.115 — Juvenile idiopathic scoliosis, thoracolumbar region
- M41.117 — Juvenile idiopathic scoliosis, lumbosacral region
- M41.122 — Adolescent idiopathic scoliosis, cervical region
- M41.123 — Adolescent idiopathic scoliosis, cervicothoracic region
- M41.124 — Adolescent idiopathic scoliosis, thoracic region
- M41.125 — Adolescent idiopathic scoliosis, thoracolumbar region
- M41.126 — Adolescent idiopathic scoliosis, lumbar region
- M41.127 — Adolescent idiopathic scoliosis, lumbosacral region
- M41.02 — Infantile idiopathic scoliosis, cervical region
- M41.03 — Infantile idiopathic scoliosis, cervicothoracic region
- M41.04 — Infantile idiopathic scoliosis, thoracic region
- M41.05 — Infantile idiopathic scoliosis, thoracolumbar region
- M41.06 — Infantile idiopathic scoliosis, lumbar region
- M41.07 — Infantile idiopathic scoliosis, lumbosacral region
- M41.08 — Infantile idiopathic scoliosis, sacral and sacrococcygeal region
- M41.22 — Other idiopathic scoliosis, cervical region
- M41.23 — Other idiopathic scoliosis, cervicothoracic region
- M41.24 — Other idiopathic scoliosis, thoracic region
- M41.25 — Other idiopathic scoliosis, thoracolumbar region
- M41.26 — Other idiopathic scoliosis, lumbar region
- M41.27 — Other idiopathic scoliosis, lumbosacral region
- M41.34 — Thoracogenic scoliosis, thoracic region
- M41.35 — Thoracogenic scoliosis, thoracolumbar region
- M41.41 — Neuromuscular scoliosis, occipito-atlanto-axial region
- M41.42 — Neuromuscular scoliosis, cervical region
- M41.43 — Neuromuscular scoliosis, cervicothoracic region
- M41.44 — Neuromuscular scoliosis, thoracic region
Frequently asked questions
Does Medicare cover M41.116 (Juvenile idiopathic scoliosis, lumbar region)?
Medicare covers items and services, not diagnoses. 5 Medicare billing and coding articles list M41.116 as a covered diagnosis for 10 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 M41.116?
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); A9585 (Injection, gadobutrol, 0.1 ml, 1 article); Q9953 (Injection, iron-based magnetic resonance contrast agent…, 1 article); G0152 (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 M41.116?
A57604 (Billing and Coding: Intraoperative Neurophysiological Testing); A56722 (Billing and Coding: Intraoperative Neurophysiological Testing); A57206 (Billing and Coding: Lumbar MRI), and 2 more articles.
What is ICD-10-CM code M41.116?
M41.116 is the ICD-10-CM code for juvenile idiopathic scoliosis, lumbar region, in category M41 (Scoliosis), 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