M45.0: Ankylosing spondylitis of multiple sites in spine
M45.0, ankylosing spondylitis of multiple sites in spine, is listed as a covered diagnosis in 6 Medicare billing and coding articles that apply to 24 HCPCS Level II codes, including J1745 (Injection, infliximab, excludes biosimilar, 10 mg), Q5104 (Injection, infliximab-abda, biosimilar, (renflexis), 10 mg), Q5103 (Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg). 4 of these codes have a 2026 DMEPOS fee schedule amount; E0783 pays $9,917.33 to $11,667.45 (NU) depending on the state. 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 M45.0 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J1745 | Injection, infliximab, excludes biosimilar, 10 mg | Special coverage instructions apply | — | 2 |
| Q5104 | Injection, infliximab-abda, biosimilar, (renflexis), 10 mg | Special coverage instructions apply | — | 2 |
| Q5103 | Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg | Special coverage instructions apply | — | 2 |
| Q5121 | Injection, infliximab-axxq, biosimilar, (avsola), 10 mg | Carrier judgment | — | 2 |
| J9312 | Injection, rituximab, 10 mg | Special coverage instructions apply | — | 1 |
| Q5123 | Injection, rituximab-arrx, biosimilar, (riabni), 10 mg | Carrier judgment | — | 1 |
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | Carrier judgment | — | 1 |
| Q5115 | Injection, rituximab-abbs, biosimilar, (truxima), 10 mg | Special coverage instructions apply | — | 1 |
| J9260 | Injection, methotrexate sodium, 50 mg | Special coverage instructions apply | — | 1 |
| J9215 | Injection, interferon, alfa-n3, (human leukocyte derived), 250,000 iu | Special coverage instructions apply | — | 1 |
| E0783 | Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.) | Special coverage instructions apply | $9,917.33–$11,667.45 (NU) | 1 |
| E0786 | Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter) | Special coverage instructions apply | $10,969.75–$11,380.88 (NU) | 1 |
| E0782 | Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.) | Special coverage instructions apply | $5,200.92–$6,118.73 (NU) | 1 |
| E0785 | Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement | Special coverage instructions apply | $572.38–$673.39 (KF) | 1 |
| J7999 | Compounded drug, not otherwise classified | Special coverage instructions apply | — | 1 |
| J2278 | Injection, ziconotide, 1 microgram | Special coverage instructions apply | — | 1 |
| J2274 | Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg | Special coverage instructions apply | — | 1 |
| A4220 | Refill kit for implantable infusion pump | Special coverage instructions apply | — | 1 |
| J9200 | Injection, floxuridine, 500 mg | Special coverage instructions apply | — | 1 |
| A9585 | Injection, gadobutrol, 0.1 ml | Carrier judgment | — | 1 |
| Q9953 | Injection, iron-based magnetic resonance contrast agent, per ml | Special coverage instructions apply | — | 1 |
| 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 | — | 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 M45.0
- A56432: Billing and Coding: Infliximab (Palmetto GBA (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L35677
- A55639: Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 6 Level II codes)
- A52423: Billing and Coding: Infliximab and biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B); 4 Level II codes)
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B); 9 Level II codes). LCD with the same title: L33461
- 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
- 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 M45 diagnoses (Ankylosing spondylitis)
- M45.1 — Ankylosing spondylitis of occipito-atlanto-axial region
- M45.2 — Ankylosing spondylitis of cervical region
- M45.3 — Ankylosing spondylitis of cervicothoracic region
- M45.4 — Ankylosing spondylitis of thoracic region
- M45.5 — Ankylosing spondylitis of thoracolumbar region
- M45.6 — Ankylosing spondylitis lumbar region
- M45.7 — Ankylosing spondylitis of lumbosacral region
- M45.8 — Ankylosing spondylitis sacral and sacrococcygeal region
Frequently asked questions
Does Medicare cover M45.0 (Ankylosing spondylitis of multiple sites in spine)?
Medicare covers items and services, not diagnoses. 6 Medicare billing and coding articles list M45.0 as a covered diagnosis for 24 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 M45.0?
The Level II codes from the policies most specific to this diagnosis are J1745 (Injection, infliximab, excludes biosimilar, 10 mg, 2 articles); Q5104 (Injection, infliximab-abda, biosimilar, (renflexis), 10 mg, 2 articles); Q5103 (Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg, 2 articles); Q5121 (Injection, infliximab-axxq, biosimilar, (avsola), 10 mg, 2 articles); J9312 (Injection, rituximab, 10 mg, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with M45.0?
Under the 2026 DMEPOS fee schedule (non-rural state fees): E0783 $9,917.33 to $11,667.45 (NU); E0786 $10,969.75 to $11,380.88 (NU); E0782 $5,200.92 to $6,118.73 (NU); E0785 $572.38 to $673.39 (KF). Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list M45.0?
A56432 (Billing and Coding: Infliximab); A55639 (Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions); A52423 (Billing and Coding: Infliximab and biosimilars), and 3 more articles.
What is ICD-10-CM code M45.0?
M45.0 is the ICD-10-CM code for ankylosing spondylitis of multiple sites in spine, in category M45 (Ankylosing spondylitis), chapter 13: Diseases of the musculoskeletal system and connective tissue.
Next steps
- Run a reimbursement report for a device billed under J1745
- Watch J1745 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1745
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