1. ICD-10-CM Codes
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2. M00-M99 Diseases of the musculoskeletal system and connective tissue
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3. M50-M54 Other dorsopathies
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4. M54- Dorsalgia
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2018/2019 ICD-10-CM Diagnosis Code M54.3

Sciatica

2016 2017 2018 2019 Non-Billable/Non-Specific Code

• M54.3 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail.
• The 2018/2019 edition of ICD-10-CM M54.3 became effective on October 1, 2018.
• This is the American ICD-10-CM version of M54.3 - other international versions of ICD-10 M54.3 may differ.

• A condition characterized by pain radiating from the back into the buttock and posterior/lateral aspects of the leg. Sciatica may be a manifestation of sciatic neuropathy; radiculopathy (involving the spinal nerve roots; l4, l5, s1, or s2, often associated with intervertebral disk displacement); or lesions of the cauda equina.
• Lower back pain radiating to the buttocks
• Sciatica is a symptom of a problem with the sciatic nerve, a large nerve that runs from the lower back down the back of each leg. It controls muscles in the back of your knee and lower leg and provides feeling to the back of your thigh, part of your lower leg and the sole of your foot. When you have sciatica, you have pain, weakness, numbness or tingling. It can start in the lower back and extend down your leg to your calf, foot, or even your toes. It's usually on only one side of your body.sciatica may be due to a ruptured intervertebral disk, narrowing of the spinal canal that puts pressure on the nerve called spinal stenosis, or an injury such as a pelvic fracture. In many cases no cause can be found.sometimes sciatica goes away on its own. Treatment, if needed, depends on the cause of the problem. It may include exercises, medicines and surgery.
• Syndrome characterized by pain radiating from the back into the buttock and into the lower extremity along its posterior or lateral aspect, and most commonly caused by protrusion of a low lumbar intervertebral disk; also used to refer to pain anywhere along the course of the sciatic nerve.

• 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

• Type 1 Excludes: G57.0
  , M51.1
  , M79.2
  ICD-10-CM Diagnosis Code G57.0

  Lesion of sciatic nerve

  2016 2017 2018 2019 Non-Billable/Non-Specific Code

  Type 1 Excludes

  • sciatica NOS (M54.3-)

  Type 2 Excludes

  • sciatica attributed to intervertebral disc disorder (M51.1.-)
  ICD-10-CM Diagnosis Code M51.1

  Thoracic, thoracolumbar and lumbosacral intervertebral disc disorders with radiculopathy

  2016 2017 2018 2019 Non-Billable/Non-Specific Code

  Applicable To

  • Sciatica due to intervertebral disc disorder

  Type 1 Excludes

  • lumbar radiculitis NOS (M54.16)
  • sciatica NOS (M54.3)
  ICD-10-CM Diagnosis Code M79.2

  Neuralgia and neuritis, unspecified

  2016 2017 2018 2019 Billable/Specific Code

  Type 1 Excludes

  • brachial radiculitis NOS (M54.1)
  • lumbosacral radiculitis NOS (M54.1)
  • mononeuropathies (G56-G58)
  • radiculitis NOS (M54.1)
  • sciatica (M54.3-M54.4)

• Sciatica (infective)
  • wallet M54.3-

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