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- M54.5 (Low back pain, unspecified): Code M54.5 is used for a nonspecific diagnosis of low back pain, without assigning a cause. Code M54.5 is one of the most commonly used codes in clinical settings, especially physical therapy, where detailed diagnoses have not been established.
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This August, CMS published its latest round of ICD-10 changes—including the deletion of ICD-10 code M54.5, low back pain, effective October 1, 2021. That means providers cannot use M54.5 to specify a diagnosis on or after October 1—and existing patients with the M54.5 diagnosis will need to be updated to a valid ICD-10 code.
ICD 10 code for Low back pain. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code M54.5.
Still, using M54.5 to classify uncomplicated low back pain without radiculopathy already pinpoints physical therapy as the ideal initial treatment instead of further special imaging or surgery consultations.
Nov 7, 2022 · To help coders report patient care to the highest specificity, ICD-10 2022 divided M54.5 (Low back pain) into three new codes that take this definition into account: M54.50 (Low back pain, unspecified) M54.51 (Vertebrogenic low back pain) M54.59 (Other low back pain)
May 30, 2024 · M54.5 (Low back pain, unspecified): Code M54.5 is used for a nonspecific diagnosis of low back pain, without assigning a cause. Code M54.5 is one of the most commonly used codes in clinical settings, especially physical therapy, where detailed diagnoses have not been established.
Mar 1, 2023 · M54.50 Low back pain, unspecified. This diagnosis code includes loin pain and lumbago not otherwise specified (NOS). This code is appropriate when the physician is unable to provide a more specified diagnosis or reasoning for the pain without additional testing.
Unlike its parent code, M54.5, which became non-billable in 2023, M54.50 encompasses a broader range of non-specific lower back pain presentations. This means it can be used for cases where the exact cause or contributing factors remain unclear, but the pain itself significantly impacts the patient's well-being.