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Home/Diagnosis/ICD-10 Coding for Backache

ICD-10 Coding for Backache

M54.5
M54.41

Complete ICD-10-CM coding and documentation guide for icd-10 coding for backache includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Low Back Pain
Lumbago
Back Pain
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Key Information: ICD-10 Coding for Backache

Essential facts and insights about ICD-10 Coding for Backache

Use ICD-10 code M54.5 for low back pain, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Low back pain

Non-Billable
M54.5
Non-Billable

Diagnostic Criteria

clinical:
  • • Pain localized to the lumbar region without radiation
coding:
  • • No concurrent use with S39.012-

Applicable To

  • • Lumbago
  • • Pain in lumbar region

Important Notes

  • • Ensure documentation specifies the absence of radiation or neurological symptoms to use M54.5.

Lumbago with sciatica, right side

Billable Code
M54.41
Billable

Diagnostic Criteria

clinical:
  • • Pain radiating to the right leg
  • • Positive straight leg raise test

Applicable To

  • • Sciatica with low back pain

Important Notes

  • • Document radiation pattern and positive neurological tests for accurate coding.
Ancillary Codes

Additional codes that may be used with this diagnosis

G89.21

Chronic pain due to trauma

Use when chronic pain is due to a traumatic event.

Frequently Asked Questions

What is the ICD-10 code for backache?

The ICD-10 code for nonspecific low back pain is M54.5. For back pain with sciatica, use M54.41 or M54.42 depending on the side affected.

How do you code chronic back pain?

Chronic back pain is coded with M54.5 for nonspecific pain, and G89.21 for chronic pain due to trauma, ensuring chronicity is documented.

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