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Home/Diagnosis/ICD-10 Coding for Lumbar Pain

ICD-10 Coding for Lumbar Pain

M54.50
M54.51
M54.59

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

Also Known as:
Lower Back Pain
Lumbago
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Key Information: ICD-10 Coding for Lumbar Pain

Essential facts and insights about ICD-10 Coding for Lumbar Pain

Use ICD-10 code M54.50 for low back pain, unspecified, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Low back pain, unspecified

Billable Code
M54.50
Billable

Diagnostic Criteria

documentation:
  • Lack of specific etiology or location in the documentation

Applicable To

  • • General low back pain

Important Notes

  • • Ensure documentation supports the use of an unspecified code.

Vertebrogenic low back pain

Billable Code
M54.51
Billable

Diagnostic Criteria

documentation:
  • MRI showing Modic changes

Applicable To

  • • Low back pain with vertebral origin

Important Notes

  • • Ensure MRI findings are documented.

Other specified low back pain

Billable Code
M54.59
Billable

Diagnostic Criteria

documentation:
  • Documentation of specific type of low back pain

Applicable To

  • • Muscular origin low back pain

Important Notes

  • • Ensure specific type of pain is documented.
Ancillary Codes

Additional codes that may be used with this diagnosis

G89.11

Acute pain due to trauma

Use when acute lumbar pain is due to a traumatic event.

G89.21

Chronic pain due to trauma

Use for chronic vertebrogenic pain with a traumatic origin.

Frequently Asked Questions

What is the ICD-10 code for unspecified lumbar pain?

The ICD-10 code for unspecified lumbar pain is M54.50. It is used when the documentation does not specify the type or cause of lumbar pain.

How do you code vertebrogenic lumbar pain?

Vertebrogenic lumbar pain is coded as M54.51, which requires MRI confirmation of Modic changes.

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