billable icd 10 code for back pain

by Malvina Dach DVM 4 min read

Low back pain, unspecified
M54. 50 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM M54. 50 became effective on October 1, 2021.

What ICD 10 cm code(s) are reported?

What is ICD-10-CM, ICD-10-PCS, CPT, and HCPCS?

  • ICD-10-CM, ICD-10-PCS, CPT, and HCPCS. If you are new to medical coding, you may not know what these acronyms mean. ...
  • Acronyms
  • Code Sets and Their Definitions. The following are the definitions for each code set. CMS maintains this code set, except for dental services (D codes).

What is the diagnosis code for back pain?

Low back pain, unspecified

  • M54.50 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • ICD-10-CM M54.50 is a new 2022 ICD-10-CM code that became effective on October 1, 2021.
  • This is the American ICD-10-CM version of M54.50 - other international versions of ICD-10 M54.50 may differ.

What is the ICD 10 code for intractable back pain?

Code: M54.5 Code Name: ICD-10 Code for Low back pain Block: Other dorsopathies (M50-M54) Excludes 1: current injury - see injury of spine by body region discitis NOS (M46.4-) Details: Low back pain Loin pain Lumbago NOS Excludes 1: low back strain (S39.012) lumbago due to intervertebral disc displacement (M51.2-) lumbago with sciatica (M54.4-) M54

How do you code acute on chronic back pain?

  • G89.0 Central pain syndrome Chronic Condition.
  • G89.11-G89.18 G89.1 Acute pain, not elsewhere classified.
  • G89.21-G89.29 G89.2 Chronic pain, not elsewhere classified.
  • G89.3 Neoplasm related pain (acute) (chronic) Chronic Condition.
  • G89.4 Chronic pain syndrome.
  • G89.


What is the ICD-10 diagnosis code for back pain?

5 – Low Back Pain. ICD-Code M54. 5 is a billable ICD-10 code used for healthcare diagnosis reimbursement of chronic low back pain.

What is the ICD-10-CM code for lower back pain?

M54. 50 (Low back pain, unspecified) M54. 51 (Vertebrogenic low back pain)

What is the ICD-10 code for chronic lumbar pain?

5 - Low back pain is a sample topic from the ICD-10-CM. To view other topics, please log in or purchase a subscription. ICD-10-CM 2022 Coding Guide™ from Unbound Medicine.

What is the diagnosis for back pain?

Lower back pain, sometimes called lumbago, is not a specific disease diagnosis. It's a symptom of several different types of medical problems. It usually results from a problem with one or more parts of the lower back, such as: ligaments and muscles.

What is the 2021 ICD-10 code for low back pain?

ICD-10 code M54. 5, low back pain, effective October 1, 2021. That means providers cannot use M54.

What is the ICD-10 code for upper back pain?

ICD-10 code: M54. 6 Pain in thoracic spine |

What is the ICD-10 code for chronic pain?

89.29 or the diagnosis term “chronic pain syndrome” to utilize ICD-10 code G89. 4. If not documented, other symptom diagnosis codes may be utilized.

How do you code acute on chronic back pain?

Code G89. 29 (Other chronic pain) is assigned as a secondary diagnosis. Category G89 contains codes for acute (G89. 11) and chronic (G89.

What does diagnosis M54 16 mean?

M54. 16 - Radiculopathy, lumbar region | ICD-10-CM.

What does diagnosis code m54 9 mean?

9: Dorsalgia, unspecified.

What is Dorsalgia unspecified?

Dorsalgia means back or spine pain, including low back, mid back, and sciatic pain. It does not include pain related to scoliosis, lordosis, or other specifically classified conditions.

What are the types of back pain?

Types of Back PainHerniated disc(s)Muscle strains (from overuse or poor posture)Muscle injury.Pinched/compressed nerves.Narrowing of the spinal canal (spinal stenosis)Vertebral fracture(s)Osteoporosis.The natural processes of aging.More items...

What is the most common cause of back pain?

Strains and sprains: Back strains and sprains are the most common cause of back pain. You can injure muscles, tendons or ligaments by lifting something too heavy or not lifting safely. Some people strain their back by sneezing, coughing, twisting or bending over.

What are 3 causes of lower back pain?

Low back pain caused by spinal degeneration and injury.Muscle or ligament strain. Repeated heavy lifting or a sudden awkward movement can strain back muscles and spinal ligaments. ... Bulging or ruptured disks. Disks act as cushions between the bones (vertebrae) in your spine. ... Arthritis. ... Osteoporosis.

Can all back pain be diagnosed?

Diagnostic tests have limited value But the preeminent problem is that there is no single diagnostic test that can provide an accurate back pain diagnosis. So then, many diagnostic tests have limited value, and some, such as diagnostic nerve block injections may also provide false-positive or false-negative results.

How does a doctor diagnose lower back pain?

An MRI, or Magnetic Resonance Imaging scan, provides a detailed image of spinal structures without using the radiation required with x-rays. An MRI of the spine can detect abnormalities with soft tissues, such as muscles, ligaments, and intervertebral discs.

Causes Of Back Pain

Back pain is a symptom of many various diseases and conditions. In many cases, the doctors cannot find the purpose of the pain. The main cause of back pain may be an issue with the back itself or a problem with a different part of the body. Degenerative arthritis is a wear and tear method compared with age, injury, or genetic choice.

Instructions For Back Pain ICD 10 CM

The instruction for ICD 10 CM states that if the problem of pain is known, the code is committed to the underlying diagnosis, not the pain code if the problem is known. For instance, if we encode lumbar radiculopathy as M5416, you can not allow M545 (lumbar pain) to this code.

List Of Back Pain ICD 10 CM Codes

Severe and chronic back pain (LBP) is encoded with the same ICD 10 code (M545) in the electronic health record and identified by retrospective chart verification. This prevents effective definition and data-driven instruction for billing and therapy support such as returning to work.

Where is back pain located?

Acute or chronic pain located in the posterior regions of the thorax; lumbosacral region; or the adjacent regions. If you've ever groaned, "oh, my aching back!", you are not alone. Back pain is one of the most common medical problems, affecting 8 out of 10 people at some point during their lives.

How long does back pain last?

Acute back pain comes on suddenly and usually lasts from a few days to a few weeks. Back pain is called chronic if it lasts for more than three months. most back pain goes away on its own, though it may take awhile.

How long does it take for back pain to go away?

If your back pain is severe or doesn't improve after three days, you should call your health care provider. You should also get medical attention if you have back pain following an injury.treatment for back pain depends on what kind of pain you have, and what is causing it.

What is the ICd 10 code for low back pain?

M54.5 is a valid billable ICD-10 diagnosis code for Low back pain . It is found in the 2021 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2020 - Sep 30, 2021 .

Do you include decimal points in ICD-10?

DO NOT include the decimal point when electronically filing claims as it may be rejected. Some clearinghouses may remove it for you but to avoid having a rejected claim due to an invalid ICD-10 code, do not include the decimal point when submitting claims electronically. See also: Low. back syndrome M54.5.