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Home/Diagnosis/ICD-10 Coding for Thoracolumbar Pain

ICD-10 Coding for Thoracolumbar Pain

M54.6
M54.5

Complete ICD-10-CM coding and documentation guide for icd-10 coding for thoracolumbar pain 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 Thoracolumbar Pain

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

Use ICD-10 code M54.6 for pain in thoracic spine, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Pain in thoracic spine

Billable Code
M54.6
Billable

Diagnostic Criteria

clinical:
  • • Pain localized to thoracic spine with imaging confirmation
documentation:
  • • Specify thoracic region and duration of pain

Applicable To

  • • Thoracic back pain
  • • Upper back pain

Important Notes

  • • Ensure documentation specifies the thoracic region and any associated trauma.

Low back pain

Non-Billable
M54.5
Non-Billable

Diagnostic Criteria

clinical:
  • • Clinical documentation of pain localized to lumbar region
  • • Negative for radiculopathy unless specified

Applicable To

  • • Lumbago
  • • Pain in lumbar spine

Important Notes

  • • Ensure documentation specifies lumbar region and absence of radiculopathy.
Ancillary Codes

Additional codes that may be used with this diagnosis

G89.21

Chronic pain due to trauma

Use when the encounter is primarily for pain management due to trauma.

G89.29

Other chronic pain

Use for chronic pain management when the primary focus is pain control.

Frequently Asked Questions

What is the ICD-10 code for thoracolumbar pain?

The ICD-10 code for thoracolumbar pain is M54.6 for thoracic spine pain and M54.5 for lumbar spine pain, depending on the specific location of the pain.

How is chronic thoracolumbar pain documented?

Chronic thoracolumbar pain should be documented with specific pain location, duration, and any associated trauma or imaging findings to support coding.

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