Pathophysiology, diagnosis, and treatment of discogenic low back pain. World J Orthop ... with surgical spinal fusion for the treatment of single-level degenerative disc disease: a meta-analysis of 5-year outcomes from randomized controlled trials.
Disclosures: Kuwahara reports serving as a CMS fellow and previously served as a fellow at the Association of Asian Pacific Community Health Organizations. Disclosures: Kuwahara reports serving as a CMS fellow and previously served as a fellow at the Association of Asian Pacific Community Health Organizations.
Lumbar disc disease refers to a collection of degenerative disorders that can lead to low back pain as people age. It is also known as lumbar spondylosis. There are three main processes that make up lumbar disc disease: Internal disc disruption; Degenerative disc disease; Segmental instability
The current code, M54. 5 (Low back pain), will be expanded into three more specific codes: M54. 50 (Low back pain, unspecified)
5: Low back pain.
This August, CMS published its latest round of ICD-10 changes—including the deletion of ICD-10 code M54. 5, low back pain, effective October 1, 2021. That means providers cannot use M54. 5 to specify a diagnosis on or after October 1—and existing patients with the M54.
ICD-10 Code for Intervertebral disc disorders with radiculopathy, lumbar region- M51. 16- Codify by AAPC.
6: Pain in thoracic spine.
9: Dorsalgia, unspecified.
M54. 50 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
M54. 16 - Radiculopathy, lumbar region | ICD-10-CM.
ICD-9 Code Transition: 723.1 Code M54. 2 is the diagnosis code used for Cervicalgia (Neck Pain). It is a common problem, with two-thirds of the population having neck pain at some point in their lives.
Other intervertebral disc disorders, lumbar region The 2022 edition of ICD-10-CM M51. 86 became effective on October 1, 2021.
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.
M54. 59, other low back pain is used for lower back pain that can be attributed to a specific reason but there is not an applicable code available that describes or defines it. (You can name it but it is does not have its own specific code (i.e. facet syndrome.)
For starters, dorsalgia is severe back pain, which could be coming from different parts of the spine. Depending on the specific section of the spine where the pain is coming from, there are six types of dorsalgia. These are: Cervical. Cervicothoracic.
Every October 1st brings additions and deletions to the ICD10 codes and although these are 2022 codes the effective date is October 1, 2021. The code for low back pain M54.
Spinal stenosis, lumbar region 1 Lumbar spinal stenosis no neurogenic claudication 2 Lumbar spinal stenosis w neurogenic claudication 3 Myelopathy due to spinal stenosis of lumbar region 4 Neurogenic claudication co-occurrent and due to spinal stenosis of lumbar region 5 Neurogenic claudication due to spinal stenosis of lumbar region 6 Spinal stenosis lumbar region 7 Spinal stenosis lumbar region, neurogenic claudicati 8 Spinal stenosis of lumbar region 9 Spinal stenosis of lumbar region with myelopathy 10 Spinal stenosis of lumbar region without neurogenic claudication 11 Spinal stenosis of lumbar spine 12 Stenosis of lumbar spine with myelopathy
The 2022 edition of ICD-10-CM M48.06 became effective on October 1, 2021.
Though it is not specifically mentioned, “thoracolumbar” likely only includes T12-L1, and “lumbosacral” probably only refers to the L5-S1 interspace. There is a strange rule for cervical disc disorders indicating that you should code to the most superior level of the disorder.
Only use the fourth character “9” for unspecified disc disorders if the documentation does not indicate anything more than the presence of a disc problem. But beware, payors are expected to ask for clarification if unspecified or “NOS” codes are used.
9 = unspecified disc disorder. The fifth character provides detail about the anatomical location within the spinal region. A basic knowledge of spinal anatomy should make fifth-character selection easy, but only if it is documented properly. This includes transitionary regions.
These spinal disc codes appear to be a bit complex, but with some study and evaluation, the logic used to create them becomes clear. The provider can use the codes to guide proper documentation and the coder then can select the right codes with confidence.
It is already included in the code. Likewise, don’t code sciatica (M54.3-) if you code for lumbar disc with radiculopathy. It would be redundant. On a side note, lumbar radiculopathy (M54.16) might be used if pain is not yet known to be due a disc, but it radiates from the lumbar spine.