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Home/Diagnosis/ICD-10 Coding for Lumbago with Sciatica

ICD-10 Coding for Lumbago with Sciatica

M54.41
M54.42
M54.40

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

Also Known as:
Low Back Pain with Sciatica
Back Pain with Radiculopathy
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Key Information: ICD-10 Coding for Lumbago with Sciatica

Essential facts and insights about ICD-10 Coding for Lumbago with Sciatica

Use ICD-10 code M54.41 for lumbago with sciatica, right side, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Lumbago with sciatica, right side

Billable Code
M54.41
Billable

Diagnostic Criteria

  • • Presence of right-sided low back pain with leg radiation

Applicable To

  • • Low back pain with right-sided sciatica

Important Notes

  • • Ensure laterality is documented to avoid unspecified coding.

Lumbago with sciatica, left side

Billable Code
M54.42
Billable

Diagnostic Criteria

  • • Presence of left-sided low back pain with leg radiation

Applicable To

  • • Low back pain with left-sided sciatica

Important Notes

  • • Ensure laterality is documented to avoid unspecified coding.

Lumbago with sciatica, unspecified side

Billable Code
M54.40
Billable

Diagnostic Criteria

  • • Low back pain with leg radiation, side not specified

Applicable To

  • • Low back pain with sciatica, unspecified side

Important Notes

  • • Encourage documentation of laterality to avoid unspecified coding.
Frequently Asked Questions

What is the ICD-10 code for lumbago with sciatica?

The ICD-10 codes for lumbago with sciatica are M54.41 for the right side, M54.42 for the left side, and M54.40 for unspecified side.

When should M51.16 be used instead of M54.42?

Use M51.16 when sciatica is due to a confirmed disc disorder, as indicated by imaging, instead of M54.42.

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