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.
Back pain ICD-10 codes
Start with the primary code, then move to a more specific related code when the documentation supports it.
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 |
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.-.
“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.”
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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I10ICD-10-CM
Essential (primary) hypertension
Näyttö: “Chief Complaint Elevated and fluctuating blood pressure readings.”
E78.5ICD-10-CM
Hyperlipidemia, unspecified
Näyttö: “2. Hyperlipidemia. Clinically stable on atorvastatin.”
M19.90ICD-10-CM
Unspecified osteoarthritis, unspecified site
Näyttö: “3. Osteoarthritis. Symptoms stable. Continue conservative management with acetaminophen as needed.”
FactsContext extracts clinical facts first: diagnoses, symptoms, negatives, findings, test results, medications, and plan decisions.
The clinician can read and reuse the extracted medical context directly, independent of the generated note.
AI suggestions are not a substitute for clinician judgment, payer rules, local coding policy, or the official code set.
FAQ
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.