Payment Issues

Discontinued code:
M51.36 (other intervertebral disc degeneration, lumbar region

Replacement codes:
M51.360 (other intervertebral disc degeneration, lumbar region with discogenic back pain only);
M51.361 (other intervertebral disc degeneration, lumbar region with lower extremity pain only);
M51.362 (other intervertebral disc degeneration, lumbar region with discogenic back pain and lower extremity pain); and
M51.369 (other intervertebral disc degeneration, lumbar region without mention of lumbar back pain or lower extremity pain).

Discontinued code:
M51.37 other intervertebral disc degeneration lumbosacral region

Replacement codes:
M51.370 (other intervertebral disc degeneration, lumbosacral region with discogenic back pain only);
M51.371 (other intervertebral disc degeneration, lumbosacral region with lower extremity pain only);
M51.372 (other intervertebral disc degeneration, lumbosacral region with discogenic back pain and lower extremity pain);
M51.379 (other intervertebral disc degeneration, lumbosacral region without mention of lumbar back pain or lower extremity pain); and
M62.85 (dysfunction of the multifidus muscles, lumbar region).
M65.9  synovitis and tenosynovitis, unspecified
M65.90 (unspecified synovitis and tenosynovitis, unspecified site);
M65.911 (unspecified synovitis and tenosynovitis, right shoulder);
M65.912 (unspecified synovitis and tenosynovitis, left shoulder);
M65.919 (unspecified synovitis and tenosynovitis, unspecified shoulder);
M65.921 (unspecified synovitis and tenosynovitis, right upper arm);
M65.922 (unspecified synovitis and tenosynovitis, left upper arm);
M65.929 (unspecified synovitis and tenosynovitis, unspecified upper arm);
M65.931 (unspecified synovitis and tenosynovitis, right forearm);
M65.932 (unspecified synovitis and tenosynovitis, left forearm);
M65.939 (unspecified synovitis and tenosynovitis, unspecified forearm);
M65.941 (unspecified synovitis and tenosynovitis, right hand);
M65.942 (unspecified synovitis and tenosynovitis, left hand);
M65.949 (unspecified synovitis and tenosynovitis, unspecified hand);
M65.951 (unspecified synovitis and tenosynovitis, right thigh);
M65.952 (unspecified synovitis and tenosynovitis, left thigh);
M65.959 (unspecified synovitis and tenosynovitis, unspecified thigh);
M65.961 (unspecified synovitis and tenosynovitis, right lower leg);
M65.962 (unspecified synovitis and tenosynovitis, left lower leg);
M65.969 (unspecified synovitis and tenosynovitis, unspecified lower leg);
M65.971 (unspecified synovitis and tenosynovitis, right ankle and foot);
M65.972 (unspecified synovitis and tenosynovitis, left ankle and foot);
M65.979 (unspecified synovitis and tenosynovitis, unspecified ankle and foot); and
M65..98 (unspecified synovitis and tenosynovitis, other site).

• April 2026 Payment Committee Report
• February 2026 Payment Committee Report
• Premera Policy Update December 22, 2025
• November 2025 Payment Committee Report
• April 2025 Payment Committee Report

For your convenience, eviCore.com includes links to clinical guidelines, clinical worksheets, and a variety of training materials: 

• Provider Hub - https://www.evicore.com/provider  
• Clinical Guidelines - https://www.evicore.com/provider/clinical-guidelines  
• Clinical Worksheets - https://www.evicore.com/provider/online-forms

 eviCore also conducts weekly authorization portal training, biweekly Provider Resource forums, and bimonthly therapy-specific portal training.  If you or anyone in your office would be interested in these sessions, you can register by following these steps: 

1. Go to www.eviCore.webex.com
2. Click on the menu (three dashes) in the upper left-hand corner of the page
3. Select “WebEx Training”
4. Click the "Upcoming" tab
5. Click "Register" next to the session you wish to attend
6. Enter your registration information