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Home/Diagnosis/ICD-10 Coding for Sciatic Pain

ICD-10 Coding for Sciatic Pain

M54.30
M54.31
M54.32

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

Also Known as:
Sciatica
Radicular Pain
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Key Information: ICD-10 Coding for Sciatic Pain

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

Use ICD-10 code M54.30 for sciatica, unspecified side, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Sciatica, unspecified side

Billable Code
M54.30
Billable

Diagnostic Criteria

  • • Pain radiating below the knee
  • • Dermatomal numbness

Applicable To

  • • Sciatica NOS

Important Notes

  • • Specify laterality whenever possible to avoid using unspecified codes.

Sciatica, right side

Billable Code
M54.31
Billable

Diagnostic Criteria

  • • Right-sided pain radiating below the knee
  • • Positive straight leg raise test

Applicable To

  • • Right-sided sciatica

Important Notes

  • • Always confirm laterality with clinical documentation.

Sciatica, left side

Billable Code
M54.32
Billable

Diagnostic Criteria

  • • Left-sided pain radiating below the knee
  • • Positive straight leg raise test

Applicable To

  • • Left-sided sciatica

Important Notes

  • • Always confirm laterality with clinical documentation.

Lumbago with sciatica

Non-Billable
M54.4
Non-Billable

Diagnostic Criteria

  • • Low back pain with radiating leg pain
  • • Limited lumbar range of motion

Applicable To

  • • Low back pain with sciatica

Important Notes

  • • Document both low back pain and sciatica for accurate coding.

Intervertebral disc disorders with radiculopathy, lumbar region

Billable Code
M51.16
Billable

Diagnostic Criteria

  • • MRI showing lumbar disc herniation
  • • Radicular symptoms correlating with imaging

Applicable To

  • • Lumbar disc herniation with radiculopathy

Important Notes

  • • Confirm disc pathology with imaging before coding.
Frequently Asked Questions

What is the ICD-10 code for sciatic pain?

The ICD-10 code for sciatic pain is M54.3, with specific codes for laterality: M54.31 for right side and M54.32 for left side.

When should M54.4 be used instead of M54.3?

Use M54.4 when both low back pain and sciatica are present, indicating lumbago with sciatica.

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