Icd 10 Code For Low Back Pain
ICD-10 Code: M54.5 – Low Back Pain – ICD-Code M54.5 is a billable ICD-10 code used for healthcare diagnosis reimbursement of chronic low back pain. Its corresponding ICD-9 code is 724.2. Billable: Yes ICD-9 Code Transition: 724.2 Code M54.5 is the diagnosis code used for Low Back Pain (LBP). This is sometimes referred to as lumbago. Other Synonyms Include:
Acute low back painC/O – loin painC/O – low back painChronic low back painComplaining of backacheFacet joint painFinding of sensation of lumbar spineIntractable low back painLoin painLow back painLow back pain in pregnancyLumbar ache – renalLumbar facet joint painLumbar spine – tenderLumbar spine painful on movementLumbar trigger point syndromeMechanical low back painMyofascial painMyofascial pain syndromeO/E – lumbar pain on palpationOn examination – abdominal pain on palpationPain in lumbar spinePain radiating to lumbar region of backPosterior compartment low back painPostural low back painSacral back painSacrocoxalgiaTenderness of left lumbarTenderness of right lumbar
Contents
What replaced M54 5?
News | Beginning Oct.1: Stop Using This ICD-10 Code for LBP In a continuing press for codes that are more specific, a single, general LBP code has been replaced with several. Date: Wednesday, September 29, 2021 One of the most commonly billed codes in the rehab industry is about to disappear: Beginning Oct.1, the International Classification of Diseases code for low back pain — M54.5 — will no longer exist in the ICD-10 listings.
- The more general code is being replaced by a series of codes related to LBP aimed at providing greater specificity around diagnosis.
- The changes come as part of annual updates to the ICD-10 that are implemented every October.
- The replacement codes, some of which are new, include designations for low back strain, lumbago due to intervertebral disc displacement, lumbago with sciatica, vertebrogenic LBP, unspecified LBP, and other LBP.
The codes must be used for patient encounters and discharges from Oct.1, 2021, through Sept.30, 2022. The entire updated ICD-10 code set can be found at the U.S. Centers for Medicare & Medicaid’s, APTA has also updated its guidance documents available on the association’s webpage on “Specificity Is Key” According to Alice Bell, PT, DPT, APTA senior payment specialist, the changes are part of an ongoing push for more detailed codes — a push that providers shouldn’t take lightly.
- In the ICD-10 world, specificity is key,” Bell said.
- It’s important to avoid listing a specific code along with a less specific code for the same condition, because that kind of combination will likely lead to denials — for instance, don’t use the code for low back strain with the more specific code for vertebrogenic low back pain, because there’s a good chance payers will push back.” Some Payers Jumped the Gun As the date for rollout of the updates neared, some payers and Medicare Administrative Contractors began requiring the new codes before the actual changeover.
The result: Some providers have had claims rejected in error. Bell says there are two ways to make things right. “If a claim has been denied based on the updates that weren’t yet in place, providers can appeal,” she said. “Another approach would be to resubmit the claim with the updated codes.” : News | Beginning Oct.1: Stop Using This ICD-10 Code for LBP
What diagnosis is M54 17?
17: Radiculopathy Lumbosacral region.
What is code M54 14?
14: Radiculopathy Thoracic region.
Is M54 16 a valid ICD-10 code?
ICD-10 code M54.16 for Radiculopathy, lumbar region is a medical classification as listed by WHO under the range – Dorsopathies.
What is Lumbago M54 42?
ICD-10 code M54.42 for Lumbago with sciatica, left side is a medical classification as listed by WHO under the range – Dorsopathies.
What does diagnosis M54 12 mean?
M54.12 Diagnosis Code: Radiculopathy, Cervical Region – Clinical Description:
M54.12 refers to a condition where a nerve root in the cervical region (neck area) is irritated or compressedSymptoms include pain, numbness, tingling, or weakness in the area served by the affected nerveCommon causes include degenerative changes in the cervical spine, herniated discs, and spinal stenosisDiagnostic tests may include physical examination, imaging studies like X-rays, CT scans, MRI, and nerve conduction studies.Treatment options depend on the underlying cause and severity, including physical therapy, medication, or surgery.
What diagnosis is M54 30?
Sciatic pain ( http://www.wikidoc.org/index.php/Sciatica_overview ) is often called sciatica and is a result of compression, irritation or inflammation of the sciatic nerve. It can also give rise to to back pain. Three things can happen when a nerve is compressed.
| ICD-10 CODE | ICD-10 CODE DESCRIPTION |
| M54.30 | Sciatica, unspecified side |
| M54.31 | Sciatica, right side |
| M54.32 | Sciatica, left side |
| M54.40 | Lumbago with sciatica, unspecified side |
| M54.41 | Lumbago with sciatica, right side |
| M54.42 | Lumbago with sciatica, left side |
https://www.cms.gov/medicare-coverage-database/staticpages/icd-10-code-lookup.aspx?KeyWord=sciatica&bc=AAAAAAAAAAACAA%3d%3d& The sciatic nerve includes branches from many nerves from Lumbar 4 to Sacral 3, and supplies sensation to nearly the whole leg.
- The sciatic nerve also innervates the muscles of the back of the thigh, and those of the leg and foot.
- Http://www.wikidoc.org/index.php/Sciatic_nerve ) Any compression or irritation of a spinal nerve root L4-S3 will give rise to symptoms in the nerve’s distribution.
- A good example of this is a spinal disc herniation.
( https://www.youtube.com/watch?v=tXlpZwA42Ck ) In this situation, a portion of the soft disc interior migrates peripherally through a tear in the annulus and results in a protrusion or herniation. The herniation can be a problem because it is “space occupying” in a confined space (spinal canal) where the nerve must travel as well.
| M51.16 | Intervertebral disc disorders with radiculopathy, lumbar region |
| M51.17 | Intervertebral disc disorders with radiculopathy, lumbosacral region |
https://www.cms.gov/medicare-coverage-database/staticpages/icd-10-code-lookup.aspx?KeyWord=disc%20&bc=AAAAAAAAAAACAA%3d%3d& Another common cause of sciatica is spinal stenosis. In this condition the sciatic nerve is compressed by overgrowth of bone and soft tissue inside of the spinal canal.
- Spinal stenosis is usually the result of long-term degenerative problems.
- Treatment of sciatica can be divided into medical or conservative treatment and surgical treatment.
- Medical or conservative treatment is pursued first because a herniated disc will resorb and become asymptomatic about 90% of the time.
Only 10% of herniated discs go on to need surgical intervention. Medical treatment of a herniated lumbar disc causing sciatica can be started with exercise and physical therapy, such as McKienze exercises ( http://www.spine-health.com/wellness/exercise/pain-relief-mckenzie-treatment ).
Other options are chiropractic and acupuncture. Other medical treatment can include medications such as an anti-inflammatory medication ( http://www.wikidoc.org/index.php/Non-steroidal_anti-inflammatory_drug ) or oral steroids ( http://www.wikidoc.org/index.php/Steroid ). Muscle relaxants and anti-depressant medications can also be used.
Epidural steroid injections are the mainstay of pain management treatment of painful sciatica. ( http://www.wikidoc.org/index.php/Epidural#Epidural_steroid_injection ) They are often given in a series of 3 injections and can be very helpful or not do much good.
| Code | Description | Medical Payment*** | |
| Non Facility* | Facility** | ||
| 62310 | Injection(s), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, includes contrast for localization when performed, epidural or subarachnoid; cervical or thoracic Nov 99.Volume 9, Issue 11, November 1999 Jan 00.Volume 10, Issue 1, January 2000 Dec 00.Volume 10, Issue 12, December 2000 Sep 04.Volume 14, Issue 9, September 2004 Jul 08.Volume 18, Issue 7, July 2008 Nov 08.Volume 18, Issue 11, November 2008 Oct 09.Volume 19, Issue 10, October 2009 Feb 10.Volume 20, Issue 2, February 2010 May 10.Volume 20, Issue 5, May 2010 Nov 10.Volume 20, Issue 11, November 2010 Jan 11.Volume 21, Issue 1, January 2011 |
https://ocm.ama-assn.org/OCM/CPTRelativeValueSearchResults.do?locality=1&keyword=epidural When conservative measures don’t work, and the symptoms are significant and persistent then surgical treatment is an option. There are a wide variety of surgical techniques to treat sciatic that depend on the cause of the sciatica.
| 62292 | Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar |
Currently there are many versions of “minimally invasive” procedures that can be performed with fluoroscopic x-ray only
| 62287 | Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle based technique to remove disc material under fluoroscopic imaging or other form of indirect visualization, with the use of an endoscope, with discography and/or epidural injection(s) at the treated level(s), when performed, single or multiple levels, lumbar Nov 99.Volume 9, Issue 11, November 1999 Mar 02.Volume 12, Issue 3, March 2002 Oct 10.Volume 20, Issue 10, October 2010 Jul 12.Volume 22, Issue 7, July 2012 Oct 12.Volume 22, Issue 10, October 2012 Apr 14.Volume 24, Issue 4, April 2014 Mar 15.Volume 25, Issue 3, March 2015 |
https://ocm.ama-assn.org/OCM/CPTRelativeValueSearchResults.do?locality=1&keyword=intervertebral+disc The disc can now be removed under direct vision with a small incision and a microscope too.
| 63030 | Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar Mar 96.Volume 6, Issue 3, March 1996 Nov 99.Volume 9, Issue 11, November 1999 Jan 01.Volume 11, Issue 1, January 2001 Feb 01.Volume 11, Issue 2, February 2001 Sep 02.Volume 12, Issue 9, September 2002 Oct 04.Volume 14, Issue 10, October 2004 Oct 08.Volume 18, Issue 10, October 2008 Oct 09.Volume 19, Issue 10, October 2009 Nov 10.Volume 20, Issue 11, November 2010 Mar 11.Volume 21, Issue 3, March 2011 Jul 11.Volume 21, Issue 7, July 2011 Jul 12.Volume 22, Issue 7, July 2012 Dec 12.Volume 22, Issue 12, December 2012 Jul 13.Volume 23, Issue 7, July 2013 Dec 13.Volume 23, Issue 12, December 2013 |
Endoscopic spine surgery is available as well as laser surgery that can be performed with or without direct vision of the disc to be removed. There are numerous techniques to perform this on an outpatient basis.
