2021 ICD-10-CM Code M54.5
Low back pain
Valid for Submission
M54.5 is a billable diagnosis code used to specify a medical diagnosis of low back pain. The code M54.5 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.
The ICD-10-CM code M54.5 might also be used to specify conditions or terms like acute low back pain, c/o - loin pain, c/o - low back pain, chronic low back pain, complaining of backache , facet joint pain, etc.
The code is commonly used in family practice, internal medicine , orthopedics medical specialties to specify clinical concepts such as back and neck pain.
Code Classification
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code M54.5:
Inclusion Terms
Inclusion TermsThese terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- Loin pain
- Lumbago NOS
Type 1 Excludes
Type 1 ExcludesA type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
Index to Diseases and Injuries
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code M54.5 are found in the index:
- - Low
- - back syndrome - M54.5
- - Lumbago, lumbalgia - M54.5
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Acute low back pain
- C/O - loin pain
- C/O - low back pain
- Chronic low back pain
- Complaining of backache
- Facet joint pain
- Finding of sensation of lumbar spine
- Finding of sensation of lumbar spine
- Finding of sensation of lumbar spine
- Finding of sensation of lumbar spine
- Intractable low back pain
- Loin pain
- Low back pain
- Low back pain in pregnancy
- Lumbar ache - renal
- Lumbar facet joint pain
- Lumbar spine - tender
- Lumbar spine painful on movement
- Mechanical low back pain
- Myofascial pain
- Myofascial pain syndrome
- Myofascial pain syndrome of lower back
- O/E - lumbar pain on palpation
- On examination - abdominal pain on palpation
- Pain in lumbar spine
- Pain radiating to lumbar region of back
- Posterior compartment low back pain
- Postural low back pain
- Sacral back pain
- Sacrocoxalgia
- Tenderness of left lumbar
- Tenderness of right lumbar
- Vertebral joint pain
Clinical Information
- LOW BACK PAIN-. 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.
Diagnostic Related Groups - MS-DRG Mapping
The ICD-10 code M54.5 is grouped in the following groups for version MS-DRG V38.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2020 through 09/30/2021.
Convert M54.5 to ICD-9 Code
- 724.2 - Lumbago
Information for Patients
Back Pain
Also called: Backache, Lumbago
If you've ever groaned, "Oh, my aching back!", you are not alone. Back pain is one of the most common medical problems, affecting 8 out of 10 people at some point during their lives. Back pain can range from a dull, constant ache to a sudden, sharp pain. Acute back pain comes on suddenly and usually lasts from a few days to a few weeks. Back pain is called chronic if it lasts for more than three months.
Most back pain goes away on its own, though it may take awhile. Taking over-the-counter pain relievers and resting can help. However, staying in bed for more than 1 or 2 days can make it worse.
If your back pain is severe or doesn't improve after three days, you should call your health care provider. You should also get medical attention if you have back pain following an injury.
Treatment for back pain depends on what kind of pain you have, and what is causing it. It may include hot or cold packs, exercise, medicines, injections, complementary treatments, and sometimes surgery.
NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases
- Back pain - returning to work (Medical Encyclopedia)
- Back pain - when you see the doctor (Medical Encyclopedia)
- Back pain and sports (Medical Encyclopedia)
- Chiropractic care for back pain (Medical Encyclopedia)
- Cognitive behavioral therapy for back pain (Medical Encyclopedia)
- Low back pain - acute (Medical Encyclopedia)
- Low back pain - chronic (Medical Encyclopedia)
- MRI and low back pain (Medical Encyclopedia)
- Sacroiliac joint pain - aftercare (Medical Encyclopedia)
- Taking care of your back at home (Medical Encyclopedia)
- Taking narcotics for back pain (Medical Encyclopedia)
[Learn More in MedlinePlus]
Code History
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)