M99.74: Connective tissue and disc stenosis of intervertebral foramina of sacral region

M99.74, connective tissue and disc stenosis of intervertebral foramina of sacral region, is listed as a covered diagnosis in 7 Medicare billing and coding articles that apply to 11 HCPCS Level II codes, including G0453 (Continuous intraoperative neurophysiology monitoring, from…), E0783 (Infusion pump system, implantable, programmable (includes…), E0786 (Implantable programmable infusion pump, replacement…). 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 6 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 M99.74 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
G0453Continuous 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—1
E0783Infusion 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
E0786Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)Special coverage instructions apply$10,969.75–$11,380.88 (NU)1
E0782Infusion 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
E0785Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacementSpecial coverage instructions apply$572.38–$673.39 (KF)1
J7999Compounded drug, not otherwise classifiedSpecial coverage instructions apply—1
J2278Injection, ziconotide, 1 microgramSpecial coverage instructions apply—1
J2274Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mgSpecial coverage instructions apply—1
A4220Refill kit for implantable infusion pumpSpecial coverage instructions apply—1
J9200Injection, floxuridine, 500 mgSpecial coverage instructions apply—1
G0255Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerveNon-covered by MedicareNot covered5

Medicare policy articles listing M99.74

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 M99 diagnoses (Biomechanical lesions, not elsewhere classified)

Frequently asked questions

Does Medicare cover M99.74 (Connective tissue and disc stenosis of intervertebral…)?

Medicare covers items and services, not diagnoses. 7 Medicare billing and coding articles list M99.74 as a covered diagnosis for 11 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 M99.74?

The Level II codes from the policies most specific to this diagnosis are G0453 (Continuous intraoperative neurophysiology monitoring, from…, 1 article); E0783 (Infusion pump system, implantable, programmable (includes…, 1 article); E0786 (Implantable programmable infusion pump, replacement…, 1 article); E0782 (Infusion pump, implantable, non-programmable (includes all…, 1 article); E0785 (Implantable intraspinal (epidural/intrathecal) catheter…, 1 article). Code choice depends on the item supplied; check each code's descriptor.

What does Medicare pay for equipment billed with M99.74?

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 M99.74?

A56722 (Billing and Coding: Intraoperative Neurophysiological Testing); A57307 (Billing and Coding: Nerve Conduction Studies and Electromyography); A57478 (Billing and Coding: Nerve Conduction Studies and Electromyography), and 4 more articles.

What is ICD-10-CM code M99.74?

M99.74 is the ICD-10-CM code for connective tissue and disc stenosis of intervertebral foramina of sacral region, in category M99 (Biomechanical lesions, not elsewhere classified), chapter 13: Diseases of the musculoskeletal system and connective tissue.

Next steps

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