ICD-10 category · Chapter XIII · M95-M99

M99 Biomechanical lesions, not elsewhere classified

81 codes under M99 in the South African Master Industry Table 2021, 65 valid for clinical use; 18 marked as a Prescribed Minimum Benefit.

Valid: the code is at its most specific level and may go on an account. Heading only: code to a more specific entry beneath it. PMB and CDL: a Prescribed Minimum Benefit or Chronic Disease List condition per the Council for Medical Schemes. † dagger and * asterisk codes are used as a pair. How to read the table
Code	Description	Use	Benefits
M99	Biomechanical lesions, not elsewhere classified	Heading only	—
M99.0	Segmental and somatic dysfunction	Heading only	—
M99.00	Segmental and somatic dysfunction, head region	Valid · may be primary	—
M99.01	Segmental and somatic dysfunction, cervical region	Valid · may be primary	—
M99.02	Segmental and somatic dysfunction, thoracic region	Valid · may be primary	—
M99.03	Segmental and somatic dysfunction, lumbar region	Valid · may be primary	—
M99.04	Segmental and somatic dysfunction, sacral region	Valid · may be primary	—
M99.05	Segmental and somatic dysfunction, pelvic region	Valid · may be primary	—
M99.06	Segmental and somatic dysfunction, lower extremity	Valid · may be primary	—
M99.07	Segmental and somatic dysfunction, upper extremity	Valid · may be primary	—
M99.08	Segmental and somatic dysfunction, rib cage	Valid · may be primary	—
M99.09	Segmental and somatic dysfunction, abdomen and other	Valid · may be primary	—
M99.1	Subluxation complex (vertebral)	Heading only	—
M99.10	Subluxation complex (vertebral), head region	Valid · may be primary	PMB 109A Vertebral dislocations/ fractures, open or closed with injury to spinal cord · Repair /reconstruction; medical management; inpatient rehabilitation up to 2 months
M99.11	Subluxation complex (vertebral), cervical region	Valid · may be primary	PMB 109A Vertebral dislocations/ fractures, open or closed with injury to spinal cord · Repair /reconstruction; medical management; inpatient rehabilitation up to 2 months
M99.12	Subluxation complex (vertebral), thoracic region	Valid · may be primary	PMB 109A Vertebral dislocations/ fractures, open or closed with injury to spinal cord · Repair /reconstruction; medical management; inpatient rehabilitation up to 2 months
M99.13	Subluxation complex (vertebral), lumbar region	Valid · may be primary	PMB 109A Vertebral dislocations/ fractures, open or closed with injury to spinal cord · Repair /reconstruction; medical management; inpatient rehabilitation up to 2 months
M99.14	Subluxation complex (vertebral), sacral region	Valid · may be primary	PMB 109A Vertebral dislocations/ fractures, open or closed with injury to spinal cord · Repair /reconstruction; medical management; inpatient rehabilitation up to 2 months
M99.15	Subluxation complex (vertebral), pelvic region	Heading only	—
M99.16	Subluxation complex (vertebral), lower extremity	Heading only	—
M99.17	Subluxation complex (vertebral), upper extremity	Heading only	—
M99.18	Subluxation complex (vertebral), rib cage	Heading only	—
M99.19	Subluxation complex (vertebral), abdomen and other	Heading only	—
M99.2	Subluxation stenosis of neural canal	Heading only	—
M99.20	Subluxation stenosis of neural canal, head region	Valid · may be primary	PMB 109A Vertebral dislocations/ fractures, open or closed with injury to spinal cord · Repair /reconstruction; medical management; inpatient rehabilitation up to 2 months
M99.21	Subluxation stenosis of neural canal, cervical region	Valid · may be primary	PMB 109A Vertebral dislocations/ fractures, open or closed with injury to spinal cord · Repair /reconstruction; medical management; inpatient rehabilitation up to 2 months
M99.22	Subluxation stenosis of neural canal, thoracic region	Valid · may be primary	PMB 109A Vertebral dislocations/ fractures, open or closed with injury to spinal cord · Repair /reconstruction; medical management; inpatient rehabilitation up to 2 months
M99.23	Subluxation stenosis of neural canal, lumbar region	Valid · may be primary	PMB 109A Vertebral dislocations/ fractures, open or closed with injury to spinal cord · Repair /reconstruction; medical management; inpatient rehabilitation up to 2 months
M99.24	Subluxation stenosis of neural canal, sacral region	Valid · may be primary	PMB 109A Vertebral dislocations/ fractures, open or closed with injury to spinal cord · Repair /reconstruction; medical management; inpatient rehabilitation up to 2 months
M99.3	Osseous stenosis of neural canal	Heading only	—
M99.30	Osseous stenosis of neural canal, head region	Valid · may be primary	PMB 941A Spinal cord compression, ischaemia or degenerative disease NOS · Medical and surgical management
M99.31	Osseous stenosis of neural canal, cervical region	Valid · may be primary	PMB 941A Spinal cord compression, ischaemia or degenerative disease NOS · Medical and surgical management
M99.32	Osseous stenosis of neural canal, thoracic region	Valid · may be primary	PMB 941A Spinal cord compression, ischaemia or degenerative disease NOS · Medical and surgical management
M99.33	Osseous stenosis of neural canal, lumbar region	Valid · may be primary	PMB 941A Spinal cord compression, ischaemia or degenerative disease NOS · Medical and surgical management
M99.34	Osseous stenosis of neural canal, sacral region	Valid · may be primary	—
M99.4	Connective tissue stenosis of neural canal	Heading only	—
M99.40	Connective tissue stenosis of neural canal, head region	Valid · may be primary	—
M99.41	Connective tissue stenosis of neural canal, cervical region	Valid · may be primary	—
M99.42	Connective tissue stenosis of neural canal, thoracic region	Valid · may be primary	—
M99.43	Connective tissue stenosis of neural canal, lumbar region	Valid · may be primary	—
M99.44	Connective tissue stenosis of neural canal, sacral region	Valid · may be primary	—
M99.5	Intervertebral disc stenosis of neural canal	Heading only	—
M99.50	Intervertebral disc stenosis of neural canal, head region	Valid · may be primary	PMB 941A Spinal cord compression, ischaemia or degenerative disease NOS · Medical and surgical management
M99.51	Intervertebral disc stenosis of neural canal, cervical region	Valid · may be primary	PMB 941A Spinal cord compression, ischaemia or degenerative disease NOS · Medical and surgical management
M99.52	Intervertebral disc stenosis of neural canal, thoracic region	Valid · may be primary	PMB 941A Spinal cord compression, ischaemia or degenerative disease NOS · Medical and surgical management
M99.53	Intervertebral disc stenosis of neural canal, lumbar region	Valid · may be primary	PMB 941A Spinal cord compression, ischaemia or degenerative disease NOS · Medical and surgical management
M99.54	Intervertebral disc stenosis of neural canal, sacral region	Valid · may be primary	—
M99.6	Osseous and subluxation stenosis of intervertebral foramina	Heading only	—
M99.60	Osseous and subluxation stenosis of intervertebral foramina, head region	Valid · may be primary	—
M99.61	Osseous and subluxation stenosis of intervertebral foramina, cervical region	Valid · may be primary	—
M99.62	Osseous and subluxation stenosis of intervertebral foramina, thoracic region	Valid · may be primary	—
M99.63	Osseous and subluxation stenosis of intervertebral foramina, lumbar region	Valid · may be primary	—
M99.64	Osseous and subluxation stenosis of intervertebral foramina, sacral region	Valid · may be primary	—
M99.7	Connective tissue and disc stenosis of intervertebral foramina	Heading only	—
M99.70	Connective tissue and disc stenosis of intervertebral foramina, head region	Valid · may be primary	—
M99.71	Connective tissue and disc stenosis of intervertebral foramina, cervical region	Valid · may be primary	—
M99.72	Connective tissue and disc stenosis of intervertebral foramina, thoracic region	Valid · may be primary	—
M99.73	Connective tissue and disc stenosis of intervertebral foramina, lumbar region	Valid · may be primary	—
M99.74	Connective tissue and disc stenosis of intervertebral foramina, sacral region	Valid · may be primary	—
M99.8	Other biomechanical lesions	Heading only	—
M99.80	Other biomechanical lesions, head region	Valid · may be primary	—
M99.81	Other biomechanical lesions, cervical region	Valid · may be primary	—
M99.82	Other biomechanical lesions, thoracic region	Valid · may be primary	—
M99.83	Other biomechanical lesions, lumbar region	Valid · may be primary	—
M99.84	Other biomechanical lesions, sacral region	Valid · may be primary	—
M99.85	Other biomechanical lesions, pelvic region	Valid · may be primary	—
M99.86	Other biomechanical lesions, lower extremity	Valid · may be primary	—
M99.87	Other biomechanical lesions, upper extremity	Valid · may be primary	—
M99.88	Other biomechanical lesions, rib cage	Valid · may be primary	—
M99.89	Other biomechanical lesions, abdomen and other	Valid · may be primary	—
M99.9	Biomechanical lesion, unspecified	Heading only	—
M99.90	Biomechanical lesion, unspecified, head region	Valid · may be primary	—
M99.91	Biomechanical lesion, unspecified, cervical region	Valid · may be primary	—
M99.92	Biomechanical lesion, unspecified, thoracic region	Valid · may be primary	—
M99.93	Biomechanical lesion, unspecified, lumbar region	Valid · may be primary	—
M99.94	Biomechanical lesion, unspecified, sacral region	Valid · may be primary	—
M99.95	Biomechanical lesion, unspecified, pelvic region	Valid · may be primary	—
M99.96	Biomechanical lesion, unspecified, lower extremity	Valid · may be primary	—
M99.97	Biomechanical lesion, unspecified, upper extremity	Valid · may be primary	—
M99.98	Biomechanical lesion, unspecified, rib cage	Valid · may be primary	—
M99.99	Biomechanical lesion, unspecified, abdomen and other	Valid · may be primary	—

Prescribed Minimum Benefits in M99. A medical scheme must fund the diagnosis, treatment and care of a PMB condition in full, within its rules on designated providers and treatment protocols. The PMB code and treatment component beside each code come from the Council for Medical Schemes’ PMB Coded List; the scheme decides whether a given claim qualifies.

Source and terms

Reproduced from the national table, unaltered.

The Department publishes the table for the industry to load. The ICD-10 Master Industry Table page

Codes and descriptions: ICD-10 Master Industry Table (MIT) 2021, published 16 March 2021 by the National Department of Health, Republic of South Africa. ® National Department of Health: all rights reserved. Reproduced for reference without alteration.

ICD-10 is the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, © World Health Organization. The WHO ICD-10 descriptions appear as published in the MIT.

Prescribed Minimum Benefit (PMB) and Chronic Disease List (CDL) markers: Council for Medical Schemes, PMB Coded List, as read by GreenNotes. Benefit decisions rest with each medical scheme.

Source file: ICD-10_MIT_2021_Excel_16-March_2021.xlsx. Found an error in a code or description? Write to help@greennotes.co.za.

This lookup is a reference to the published code table, not coding advice. Code assignment is the treating practitioner’s responsibility, following the South African ICD-10 Coding Standards and Guidelines and the WHO ICD-10 volumes. GreenNotes does not warrant that the table is complete or current.

This is the South African table. Most ICD-10 results online are the United States’ ICD-10-CM, a different code set that South African medical schemes do not accept. Regulation 5 of the General Regulations under the Medical Schemes Act requires the diagnostic code on every account, and the Master Industry Table is the list it is coded from.

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