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Home/Diagnosis/ICD-10 Coding for Dorsalgia

ICD-10 Coding for Dorsalgia

M54.5
M54.8
M54.9

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

Also Known as:
Back pain
Spinal pain
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Key Information: ICD-10 Coding for Dorsalgia

Essential facts and insights about ICD-10 Coding for Dorsalgia

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

documentation:
  • Documentation must specify lumbar region pain.

Applicable To

  • • Lumbago
  • • Pain in lumbar region

Important Notes

  • • Ensure documentation specifies the lumbar region to avoid using unspecified codes.

Other dorsalgia

Non-Billable
M54.8
Non-Billable

Diagnostic Criteria

documentation:
  • Use when the patient presents with thoracic or sacral pain.

Applicable To

  • • Thoracic pain
  • • Sacral pain

Important Notes

  • • Ensure documentation specifies thoracic or sacral region to avoid using unspecified codes.

Unspecified dorsalgia

Billable Code
M54.9
Billable

Diagnostic Criteria

documentation:
  • Use only when documentation does not specify the location of the back pain.

Applicable To

  • • Back pain NOS

Important Notes

  • • Avoid using unless absolutely necessary due to unspecified documentation.
Ancillary Codes

Additional codes that may be used with this diagnosis

M51.36

Other intervertebral disc degeneration, lumbar region

Use when MRI shows disc degeneration in the lumbar region.

M99.03

Segmental and somatic dysfunction of thoracic region

Use when there is segmental dysfunction in the thoracic region.

Frequently Asked Questions

What is the ICD-10 code for dorsalgia?

The ICD-10 code for unspecified dorsalgia is M54.9, but more specific codes like M54.5 for low back pain should be used when possible.

When should M54.5 be used instead of M54.9?

M54.5 should be used when the documentation specifies low back pain, whereas M54.9 is for unspecified dorsalgia.

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