· ICD-10 code M54.5 is getting the kibosh. Every year, CMS publishes updates to the ICD-10 manual, deleting unnecessary codes, adding new ones, and revising language as-needed. 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.
M54.5 is new to ICD-10 code set for the FY 2022, effective October 1, 2021. The National Center for Health Statistics (NCHS) has published an update to the ICD-10-CM diagnosis codes which became effective October 1, 2021. This is a new and revised code for the FY 2022 (October 1, 2021 - September 30, 2022).
· 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. This is the American ICD-10-CM version of M54.50 - other international versions of ICD-10 M54.50 may differ. Applicable To Loin pain Lumbago NOS
· Every October, there are changes made to the ICD-10 manual, which include replacement, removal, and addition of codes. The change this October 1st, will affect a common code used by many rehab professionals – low back pain (M54.5).
S39. 012, Low back strain. M51.
The code for back pain M54. 5 will be deleted with the addition of 3 codes to replace it. Of special note is the new vertebrogenic back pain specifying the origin of the pain from the vertebrae or spine.
The first new codes in ICD-10-CM 2021 are A84. 81 Powassan virus disease and A84. 89 Other tick-borne viral encephalitis. There are five more new codes under protozoal disease subcategory B60.
The current code, M54. 5 (Low back pain), will be expanded into three more specific codes: M54. 50 (Low back pain, unspecified)
5 is a billable ICD-10 code used for healthcare diagnosis reimbursement of chronic low back pain. Its corresponding ICD-9 code is 724.2. Code M54. 5 is the diagnosis code used for Low Back Pain (LBP).
Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body.
Other new diagnoses include: Depression, unspecified (F32. A) Irritant contact dermatitis (L24....ICD-10 Changes for 2022Acute cough (R05. ... Subacute cough (R05. ... Chronic cough (R05. ... Cough syncope (R05. ... Other specified cough (R05. ... Cough, unspecified (R05.
Note additional changes coming in April 2022 Effective April 1, 2022, medical practices can start reporting three new ICD-10-CM diagnosis codes for vaccination status: (Z28. 310 [unvaccinated for COVID-19], Z28. 311 [partially vaccinated for COVID-19], and Z28. 39 [other underimmunization status]).
ICD-10 Version:2019.
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.
It appears that both BCBS and Anthem have adopted the new low-back coding changes early. In other words, M54.5 isn't set to expire before October 1, but it seems these two payers have already adopted this change. This is highly unusual as commercial payers are usually slow to adopt ICD-10 and NCCI edit changes.
So, here’s the real question: How the heck can CMS justify deleting such a commonly used code? Well, CMS has explained that it’s deleting M54.5 because it lacks specificity (and we all know how important coding specificity is to ICD-10). To supplement this low back coding deletion, CMS suggested that providers use other, more specific codes—some which you may recognize, and some of which are totally new. Here are some potential code replacements that you can use beginning October 1:
M54.5 is new to ICD-10 code set for the FY 2022, effective October 1, 2021. The National Center for Health Statistics (NCHS) has published an update to the ICD-10-CM diagnosis codes which became effective October 1, 2021. This is a new and revised code for the FY 2022 (October 1, 2021 - September 30, 2022).
M54.5 is a billable diagnosis code used to specify a medical diagnosis of low back pain. The code M54.5 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.#N#The ICD-10-CM code M54.5 might also be used to specify conditions or terms like acute low back pain, c/o - loin pain, c/o - low back pain, chronic low back pain, complaining of backache , facet joint pain, etc.#N#The code is commonly used in family practice, internal medicine , orthopedics medical specialties to specify clinical concepts such as back and neck pain.
The 2022 changes to the ICD-10 code list takes effect this coming October 1, 2021. This year, an important change is made for one of the most common diagnosis codes for chiropractors. M54.5 – Low back pain is removed form the ICD-10 code list and replaced with codes that are more specific:
New Code: M54.50 Low back pain, unspecified. This includes Loin pain and Lumbago NOS.
The 2022 edition of ICD-10-CM M45.5 became effective on October 1, 2021.
Ankylosing spondylitis of thoracolumbar region 1 M45.5 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2 The 2021 edition of ICD-10-CM M45.5 became effective on October 1, 2020. 3 This is the American ICD-10-CM version of M45.5 - other international versions of ICD-10 M45.5 may differ.