M42.17: Adult osteochondrosis of spine, lumbosacral region
M42.17, adult osteochondrosis of spine, lumbosacral region, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 9 HCPCS Level II codes, including G0283 (Electrical stimulation (unattended), to one or more areas…), A9585 (Injection, gadobutrol, 0.1 ml), Q9953 (Injection, iron-based magnetic resonance contrast agent…). The articles come from 2 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 M42.17 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| 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 M42.17
- 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 M42 diagnoses (Spinal osteochondrosis)
- M42.11 — Adult osteochondrosis of spine, occipito-atlanto-axial region
- M42.12 — Adult osteochondrosis of spine, cervical region
- M42.13 — Adult osteochondrosis of spine, cervicothoracic region
- M42.14 — Adult osteochondrosis of spine, thoracic region
- M42.15 — Adult osteochondrosis of spine, thoracolumbar region
- M42.16 — Adult osteochondrosis of spine, lumbar region
- M42.18 — Adult osteochondrosis of spine, sacral and sacrococcygeal region
- M42.19 — Adult osteochondrosis of spine, multiple sites in spine
Frequently asked questions
Does Medicare cover M42.17 (Adult osteochondrosis of spine, lumbosacral region)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list M42.17 as a covered diagnosis for 9 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 M42.17?
The Level II codes from the policies most specific to this diagnosis are 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); G0158 (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 M42.17?
A57206 (Billing and Coding: Lumbar MRI); A53057 (Billing and Coding: Home Health Occupational Therapy); A53064 (Billing and Coding: Outpatient Occupational Therapy).
What is ICD-10-CM code M42.17?
M42.17 is the ICD-10-CM code for adult osteochondrosis of spine, lumbosacral region, in category M42 (Spinal osteochondrosis), chapter 13: Diseases of the musculoskeletal system and connective tissue.
Next steps
- Run a reimbursement report for a device billed under G0283
- Watch G0283 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0283
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