2021 ICD-10-CM Diagnosis Code M54.5

Low back pain

    2016 2017 2018 2019 2020 2021 Billable/Specific Code
  • M54.5 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • The 2021 edition of ICD-10-CM M54.5 became effective on October 1, 2020.
  • This is the American ICD-10-CM version of M54.5 - other international versions of ICD-10 M54.5 may differ.
Applicable To
  • Loin pain
  • Lumbago NOS
Type 1 Excludes
Type 1 Excludes Help
A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as M54.5. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • low back strain (
    ICD-10-CM Diagnosis Code S39.012

    Strain of muscle, fascia and tendon of lower back

      2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
    S39.012
    )
  • lumbago due to intervertebral disc displacement (
    ICD-10-CM Diagnosis Code M51.2

    Other thoracic, thoracolumbar and lumbosacral intervertebral disc displacement

      2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
    Applicable To
    • Lumbago due to displacement of intervertebral disc
    M51.2-
    )
  • lumbago with sciatica (
    ICD-10-CM Diagnosis Code M54.4

    Lumbago with sciatica

      2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
    Type 1 Excludes
    • lumbago with sciatica due to intervertebral disc disorder (M51.1-)
    M54.4-
    )
The following code(s) above M54.5 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to M54.5:
  • M00-M99
    2021 ICD-10-CM Range M00-M99

    Diseases of the musculoskeletal system and connective tissue

    Note
    • Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
    Type 2 Excludes
    • arthropathic psoriasis (L40.5-)
    • certain conditions originating in the perinatal period (P04-P96)
    • certain infectious and parasitic diseases (A00-B99)
    • compartment syndrome (traumatic) (T79.A-)
    • complications of pregnancy, childbirth and the puerperium (O00-O9A)
    • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
    • endocrine, nutritional and metabolic diseases (E00-E88)
    • injury, poisoning and certain other consequences of external causes (S00-T88)
    • neoplasms (C00-D49)
    • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
    Diseases of the musculoskeletal system and connective tissue
  • M50-M54
    2021 ICD-10-CM Range M50-M54

    Other dorsopathies

    Type 1 Excludes
    • current injury - see injury of spine by body region
    • discitis NOS (M46.4-)
    Other dorsopathies
  • M54
    ICD-10-CM Diagnosis Code M54

    Dorsalgia

      2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
    Type 1 Excludes
    • psychogenic dorsalgia (F45.41)
    Dorsalgia
Approximate Synonyms
  • Acute low back pain
  • Acute low back pain for less than 3 months
  • Acute low back pain less than 3 months
  • Chronic low back pain
  • Chronic low back pain for greater than 3 months
  • Chronic low back pain greater than 3 months
  • Chronic low back pain greater than 3 months duration
  • Low back pain for less than 3 months
  • Low back pain for less than 6 months
  • Low back pain in pregnancy
  • Low back pain less than 3 months
  • Low back pain less than 6 months
  • Low back pain without radiculopathy
  • Lumbar back pain acute,
  • Mechanical low back pain
  • Pain of lumbar, acute, for less then 3 months
Clinical Information
  • Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions.
ICD-10-CM M54.5 is grouped within Diagnostic Related Group(s) (MS-DRG v38.0):
  • 551 Medical back problems with mcc
  • 552 Medical back problems without mcc

Convert M54.5 to ICD-9-CM

Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
  • 2021 (effective 10/1/2020): No change
Code annotations containing back-references to M54.5:
  • Type 1 Excludes: R52
    , M54.8
    ICD-10-CM Diagnosis Code R52

    Pain, unspecified

      2016 2017 2018 2019 2020 2021 Billable/Specific Code
    Applicable To
    • Acute pain NOS
    • Generalized pain NOS
    • Pain NOS
    Type 1 Excludes
    • acute and chronic pain, not elsewhere classified (G89.-)
    • localized pain, unspecified type - code to pain by site, such as:
    • abdomen pain (R10.-)
    • back pain (M54.9)
    • breast pain (N64.4)
    • chest pain (R07.1-R07.9)
    • ear pain (H92.0-)
    • eye pain (H57.1)
    • headache (R51.9)
    • joint pain (M25.5-)
    • limb pain (M79.6-)
    • lumbar region pain (M54.5)
    • pelvic and perineal pain (R10.2)
    • shoulder pain (M25.51-)
    • spine pain (M54.-)
    • throat pain (R07.0)
    • tongue pain (K14.6)
    • tooth pain (K08.8)
    • renal colic (N23)
    • pain disorders exclusively related to psychological factors (F45.41)
    ICD-10-CM Diagnosis Code M54.8

    Other dorsalgia

      2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
    Type 1 Excludes
    • dorsalgia in thoracic region (M54.6)
    • low back pain (M54.5)
  • Type 2 Excludes: G89
    ICD-10-CM Diagnosis Code G89

    Pain, not elsewhere classified

      2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code
    Code Also
    • related psychological factors associated with pain (F45.42)
    Type 1 Excludes
    • generalized pain NOS (R52)
    • pain disorders exclusively related to psychological factors (F45.41)
    • pain NOS (R52)
    Type 2 Excludes

Diagnosis Index entries containing back-references to M54.5:
  • Low
    • back syndrome M54.5
  • Lumbago, lumbalgia M54.5
  • Pain(s) R52
    - see also Painful
    ICD-10-CM Diagnosis Code R52

    Pain, unspecified

      2016 2017 2018 2019 2020 2021 Billable/Specific Code
    Applicable To
    • Acute pain NOS
    • Generalized pain NOS
    • Pain NOS
    Type 1 Excludes
    • acute and chronic pain, not elsewhere classified (G89.-)
    • localized pain, unspecified type - code to pain by site, such as:
    • abdomen pain (R10.-)
    • back pain (M54.9)
    • breast pain (N64.4)
    • chest pain (R07.1-R07.9)
    • ear pain (H92.0-)
    • eye pain (H57.1)
    • headache (R51.9)
    • joint pain (M25.5-)
    • limb pain (M79.6-)
    • lumbar region pain (M54.5)
    • pelvic and perineal pain (R10.2)
    • shoulder pain (M25.51-)
    • spine pain (M54.-)
    • throat pain (R07.0)
    • tongue pain (K14.6)
    • tooth pain (K08.8)
    • renal colic (N23)
    • pain disorders exclusively related to psychological factors (F45.41)
    • spine M54.9
      ICD-10-CM Diagnosis Code M54.9

      Dorsalgia, unspecified

        2016 2017 2018 2019 2020 2021 Billable/Specific Code
      Applicable To
      • Backache NOS
      • Back pain NOS
    • loin M54.5
    • low back M54.5
    • lumbar region M54.5
  • Syndrome - see also Disease
    • low
      • back M54.5

ICD-10-CM Codes Adjacent To M54.5
M54.18 …… sacral and sacrococcygeal region
M54.2 Cervicalgia
M54.3 Sciatica
M54.30 …… unspecified side
M54.31 …… right side
M54.32 …… left side
M54.4 Lumbago with sciatica
M54.40 …… unspecified side
M54.41 …… right side
M54.42 …… left side
M54.5 Low back pain
M54.6 Pain in thoracic spine
M54.8 Other dorsalgia
M54.81 Occipital neuralgia
M54.89 Other dorsalgia
M54.9 Dorsalgia, unspecified
M60 Myositis
M60.0 Infective myositis
M60.00 Infective myositis, unspecified site
M60.000 Infective myositis, unspecified right arm
M60.001 Infective myositis, unspecified left arm

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.


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