2026 ICD-10-CM Diagnosis Code M54.16Radiculopathy, lumbar region

ICD-10-CM Codes›M00–M99›M50-M54›M54

ICD-10-CM M54.16
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

M54.16 is a billable ICD-10-CM diagnosis code for radiculopathy, lumbar region. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 551 through 552. Coders also document this condition as backache with radiating pain. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Low back pain and Spondylopathies/spondyloarthropathy (including infective).

This medical diagnosis code is frequently used in Orthopedics medical specialties to designate conditions such radiculopathy (primary).

Code Identity

ICD-10-CM Code
M54.16
Billable Status
Yes — Valid for Submission
Code Describes
Radiculopathy, lumbar region
Short Description
Radiculopathy, lumbar region
Same as the full description in the CMS dataset.
Parent Code
M54.1
Radiculopathy

Code Classification

ChapterM00–M99Diseases of the musculoskeletal system and connective tissue
SectionM50-M54Other dorsopathies
CategoryM54Dorsalgia
This CodeM54.16Radiculopathy, lumbar region

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Backache with radiating pain
  • Lumbar radicular pain
  • Lumbar radiculitis
  • Lumbar radiculopathy
  • Pain in lumbar spine
  • Radicular pain

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Neuritis(rheumatoid)
      • lumbar
    • Radiculopathy
      • lumbar region

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MUS038
Low back pain
Default principal diagnosis: inpatient No · outpatient No
CCSR MUS011
Spondylopathies/spondyloarthropathy (including infective)
Default principal diagnosis: inpatient Yes · outpatient Yes

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

Back Pain

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.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert M54.16 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
724.4 Lumbosacral neuritis NOS
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About M54.16Overview

Is M54.16 (Radiculopathy) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report radiculopathy, lumbar region on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does M54.16 group to?

When radiculopathy, lumbar region is the principal diagnosis on an inpatient stay, it groups to MS-DRG 551, 552, with relative weights from 0.9613 to 1.6761 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of M54.16?

Under the General Equivalence Mappings, radiculopathy, lumbar region converts to ICD-9-CM 724.4 (lumbosacral neuritis NOS). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.