ICD-10 M54.5: Low back pain (NOTE: replaced by M54.50 [Low back pain, unspecified] in FY 2022)
Mechanical low back pain without radiculopathy or specific etiology. In current ICD-10, use M54.50, M54.51 (vertebrogenic), M54.59 (other).
Clinical context
Mechanical low back pain without radiculopathy or specific etiology. In current ICD-10, use M54.50, M54.51 (vertebrogenic), M54.59 (other).
Documentation requirements
- Pain location and laterality
- Duration (acute, subacute, chronic)
- Functional impairment
- Absence of radicular symptoms if not specified
Common related procedures
- 97140 manual therapy
- 97110 therapeutic exercise
- 72100 lumbar X-ray
- 72148 lumbar MRI (requires PA usually)
Common payer denial patterns
- MRI 72148 without conservative trial of 4-6 weeks typically denied
- Use specific M54.5x code (50/51/59) not deprecated M54.5
Frequently asked questions
What does ICD-10 M54.5 mean?
Low back pain (NOTE: replaced by M54.50 [Low back pain, unspecified] in FY 2022)
When is this code documented?
Mechanical low back pain without radiculopathy or specific etiology. In current ICD-10, use M54.50, M54.51 (vertebrogenic), M54.59 (other).
What documentation supports this code?
Pain location and laterality; Duration (acute, subacute, chronic); Functional impairment; Absence of radicular symptoms if not specified.
What are common denials associated with this diagnosis?
MRI 72148 without conservative trial of 4-6 weeks typically denied; Use specific M54.5x code (50/51/59) not deprecated M54.5.
Related diagnoses
Sources
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