2027 ICD-10-CM Diagnosis Code M54.11Radiculopathy, occipito-atlanto-axial region
ICD-10-CM Codes›M00–M99›M50-M54›M54
- Billable — Valid for Submission
- Chronic Condition
M54.11 is a billable ICD-10-CM diagnosis code for radiculopathy, occipito-atlanto-axial region. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 73 through 74. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Spondylopathies/spondyloarthropathy (including infective).
This medical diagnosis code is frequently used in Orthopedics medical specialties to designate conditions such radiculopathy (primary).
Code Identity
Code Classification
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to M54.11: its own notes plus those printed at M54.1, M54, block M50-M54, and Chapter 13. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- current injury - see injury of spine by body region
- discitis NOS (M46.4-)
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- 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)
Notes
General instructions on how these codes are used.
- Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name M54.11, its category, or a range that includes it.
Excludes1 6
These codes carry an Excludes1 note naming M54.11: they are not reported together with it, unless the two conditions are unrelated.
- Block G50-G59 Nerve, nerve root and plexus disordersradiculitis NOS (M54.1-) names M54.1-, which includes this code
- G55 Nerve root and plexus compressions in diseases classified elsewherenerve root compression (due to) (in) dorsopathies (M53.-, M54.-) names M54.-, which includes this code
- M79.2 Neuralgia and neuritis, unspecifiedbrachial radiculitis NOS (M54.1) names M54.1, which includes this code
- M79.2 Neuralgia and neuritis, unspecifiedlumbosacral radiculitis NOS (M54.1) names M54.1, which includes this code
- M79.2 Neuralgia and neuritis, unspecifiedradiculitis NOS (M54.1) names M54.1, which includes this code
- R52 Pain, unspecifiedspine pain (M54.-) names M54.-, which includes this code
Excludes2 2
These codes carry an Excludes2 note naming M54.11: its condition is not part of those codes, and both may be reported when the patient has both.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Radiculopathy
disease involving a spinal nerve root (see spinal nerve roots) which may result from compression related to intervertebral disk displacement; spinal cord injuries; spinal diseases; and other conditions. clinical manifestations include radicular pain, weakness, and sensory loss referable to structures innervated by the involved nerve root.
Patient EducationClinical
Neck Injuries and Disorders
Any part of your neck - muscles, bones, joints, tendons, ligaments, or nerves - can cause neck problems. Neck pain is very common. Pain may also come from your shoulder, jaw, head, or upper arms.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert M54.11 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About M54.11Overview
What is the ICD-10 code for radiculopathy, occipito-atlanto-axial region?
The ICD-10-CM code for radiculopathy, occipito-atlanto-axial region is M54.11 (sometimes written as M5411). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is M54.11 (Radiculopathy) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report radiculopathy, occipito-atlanto-axial region on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does M54.11 group to?
When radiculopathy, occipito-atlanto-axial region is the principal diagnosis on an inpatient stay, it groups to MS-DRG 74, 73, with relative weights from 1.0172 to 1.5773 depending on complications. Higher weights mean higher Medicare reimbursement.
Can M54.11 be reported with M79.2?
Not as a rule. The Excludes1 note at M54.1, which applies to M54.11, lists "neuralgia and neuritis NOS (M79.2)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What is the ICD-9 equivalent of M54.11?
Under the General Equivalence Mappings, radiculopathy, occipito-atlanto-axial region converts to ICD-9-CM 723.4 (brachial neuritis NOS). The mapping is approximate, so confirm the match fits the documentation.
