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Home/Diagnosis/ICD-10 Coding for Lumbalgia

ICD-10 Coding for Lumbalgia

M54.5
M54.41
M51.16

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

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

Essential facts and insights about ICD-10 Coding for Lumbalgia

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 lumbar region without radiation.

Applicable To

  • • Lumbago

Important Notes

  • • Ensure no specific cause like strain or disc disorder is documented.

Lumbago with sciatica, right side

Billable Code
M54.41
Billable

Applicable To

  • • Right-sided sciatica

Important Notes

  • • Document laterality and neurological findings.

Intervertebral disc disorders with radiculopathy, lumbar region

Billable Code
M51.16
Billable

Applicable To

  • • Herniated disc with radiculopathy

Important Notes

  • • Primary code for disc-related radiculopathy.

Sprain and strain of lumbar spine, initial encounter

Billable Code
S33.5XXA
Billable

Applicable To

  • • Acute lumbar sprain

Important Notes

  • • Document initial encounter and mechanism.
Frequently Asked Questions

What is the ICD-10 code for lumbalgia?

The ICD-10 code for lumbalgia, commonly known as low back pain, is M54.5. This code is used for non-specific low back pain without a specific underlying cause.

How do you code lumbago with sciatica?

Lumbago with sciatica is coded as M54.41 for right-sided symptoms and M54.42 for left-sided symptoms. Ensure documentation specifies laterality and neurological findings.

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