ICD-10 codes for back pain
Since the 2022 ICD-10-CM update, the classic M54.5 "low back pain" is no longer billable in the US — it split into M54.50, M54.51, and M54.59. The WHO international edition still uses M54.5. Know which system your payer or registry expects.
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Proovige AI-toega ekstrakti nähtava meditsiinilise kontekstiga
Paste a note or record audio. Notat’s FactsContext™ engine extracts the raw clinical facts first, then suggests codes from that context so you can inspect the evidence before using anything.
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Kuidas seda tööriista kasutada
1
Kleepige või dikteerige de-identifitseeritud kliiniline märge — mõnest lausest piisab.
2
Vajutage Hanki koodid. Kodeerimissüsteem on sellel lehel fikseeritud.
3
Vaata üle iga soovitatud kood ja selle tõendid, seejärel kopeeri koodid, millega nõustute.
Kliiniline märge
Ekstraheeritud koodid
Tõendid jäävad ülevaatamiseks külge.
Kleepige kliiniline märge või laadige näidis, seejärel vajutage Hanki koodid. Soovitused ilmuvad siia koos toetavate tõenditega.
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Back pain ICD-10 codes
Start with the primary code, then move to a more specific related code when the documentation supports it.
| Kood | Kirjeldus | Süsteem |
|---|---|---|
M54.50 | Low back pain, unspecified | ICD-10-CM |
M54.5 | Low back pain WHO international edition; not billable in ICD-10-CM since 2022 | ICD-10 |
M54.51 | Vertebrogenic low back pain | ICD-10-CM |
M54.59 | Other low back pain | ICD-10-CM |
M54.41 | Lumbago with sciatica, right side | ICD-10-CM |
M54.42 | Lumbago with sciatica, left side | ICD-10-CM |
M54.16 | Radiculopathy, lumbar region | ICD-10-CM |
M51.26 | Other intervertebral disc displacement, lumbar region | ICD-10-CM |
Kuidas valida õiget koodi
For US billing, never submit M54.5 — pick M54.50 (unspecified), M54.51 (vertebrogenic, documented endplate/vertebral source), or M54.59 (other). Radiating pain below the knee with positive straight-leg raise supports lumbago with sciatica (M54.41/42, laterality required) or lumbar radiculopathy (M54.16). Documented disc pathology on imaging moves you to M51.-.
Dokumentatsiooni näide
“Acute low back pain after lifting, 5 days. Pain radiates down the left posterior thigh to the calf. SLR positive on the left at 45°. Power, reflexes, and sensation intact. No red flags. Advised to stay active; NSAIDs; physiotherapy referral.”
Soovitatud:
Mitte otsene transkripti aimamine
FactsContext extracts clinical facts first: diagnoses, symptoms, negatives, findings, test results, medications, and plan decisions.
Toorfaktid jäävad kasutatavaks
The clinician can read and reuse the extracted medical context directly, independent of the generated note.
Loodud ülevaatamiseks
AI suggestions are not a substitute for clinician judgment, payer rules, local coding policy, or the official code set.
FAQ
What is the ICD-10 code for back pain?
The ICD-10 code for back pain is M54.50 (Low back pain, unspecified). Related codes include M54.5, M54.51, M54.59. Confirm the most specific code against the documented clinical detail before billing.
Why is M54.5 rejected by US payers?
ICD-10-CM deleted M54.5 as a billable code in October 2021, replacing it with M54.50, M54.51, and M54.59. Claims with M54.5 are denied for lack of specificity.
Sciatica or radiculopathy — which code?
Lumbago with sciatica (M54.41/42) fits pain radiating along the sciatic distribution with back pain. Documented neurological findings attributable to a nerve root support lumbar radiculopathy (M54.16), and confirmed disc displacement is coded from M51.-.
Can AI pick the right back-pain code with laterality?
Notat extracts laterality, radiation, and exam findings as clinical facts and suggests the specific code — M54.42 rather than M54.5 — with the sentence that supports it.
Seotud ICD-10 juhendid
Jätkake liikumist haiguse jaotises või avage üldine meditsiinilise kodeerimise juhend täiendavate kodeerimissüsteemide ja ekstraktorite jaoks.