M54.5 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2021 edition of ICD-10-CM M54.5 became effective on October 1, 2020. This is the American ICD-10-CM version of M54.5 - other international versions of ICD-10 M54.5 may differ.
Treatment
CPT code 62270, 62272, 62273 - Lumbar Puncture
spondylogenic 721.91 cervical 721.1 lumbar, lumbosacral 721.42 thoracic 721.41
The current code, M54. 5 (Low back pain), will be expanded into three more specific codes: M54. 50 (Low back pain, unspecified)
S39. 012, Low back strain.
M54. 50 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
M54. 5 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. The 2022 edition of ICD-10-CM M54. 5 became effective on October 1, 2021.
9: Dorsalgia, unspecified.
The new diagnosis code – M54. 51 – went into effect on October 1, 2021. This code will be applied to patients meeting indications for treatment with basivertebral nerve radiofrequency neurotomy. Help sustain this vital advocacy with your donations.
16: Radiculopathy Lumbar region.
17: Radiculopathy Lumbosacral region.
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.
Vertebrogenic pain is a distinct type of chronic low back pain caused by damage to vertebral endplates, the interface between the disc and the vertebral body.
ICD-10 code M54. 5 for Low back pain is a medical classification as listed by WHO under the range - Dorsopathies .
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.
M54. 9 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.
ICD-10 code M54. 6 for Pain in thoracic spine is a medical classification as listed by WHO under the range - Dorsopathies .
ICD-10 code M54. 9 for Dorsalgia, unspecified is a medical classification as listed by WHO under the range - Dorsopathies .
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.)
Conditions commonly linked to back pain include muscle or ligament strain, bulging or ruptured disks, arthritis, or osteoporosis. In the case of muscle or ligament strain, repeated heavy lifting or a sudden awkward movement can strain back muscles and spinal ligaments. If you’re in poor physical condition, constant strain on your back can cause ...
Panniculitis affecting regions of neck and back, lumbosacral region. 13. M54.08. Panniculitis affecting regions of neck and back, sacral and sacrococcygeal region. 13. M54.09. Panniculitis affecting regions, ne ck and back , multiple sites in spine.
However, you can have a bulging or ruptured disk without back pain. Disk disease is often found incidentally when you have spine X-rays for some other reason. In some cases, arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis.
The ICD 10 code M545 is used to define conditions connected with acute back pain (C & O lumbar pain, C & O back pain, or chronic back pain) or complaints about back pain or facet or joint pain. This code is used in common practice, internal medicine, and orthopedic works to define clinical ideas such as neck pain. Like the billable ICD 10 code, M545 is also used for medical diagnosis and compensation of chronic back pain.
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. Although we report Radicullopathy as an ICD 10 code, we do not report the code for back pain.
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.
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.
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.