2026 ICD-10-CM Diagnosis Code M54.59Other low back pain

ICD-10-CM Codes›M00–M99›M50-M54›M54

ICD-10-CM M54.59
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

M54.59 is a billable ICD-10-CM diagnosis code for other low back pain. 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 myofascial low back pain. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Low back pain.

Code Identity

ICD-10-CM Code
M54.59
Billable Status
Yes — Valid for Submission
Code Describes
Other low back pain
Short Description
Other low back pain
Same as the full description in the CMS dataset.
Parent Code
M54.5
Low back pain

Code Classification

ChapterM00–M99Diseases of the musculoskeletal system and connective tissue
SectionM50-M54Other dorsopathies
CategoryM54Dorsalgia
This CodeM54.59Other low back pain

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Myofascial low back pain
  • Myofascial pain
  • Myofascial pain syndrome
  • Myofascial pain syndrome of lower back

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.

    • Pain(s)
      • low back
        • specified NEC

Clinical ClassificationClinical

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

CCSR MUS038
Low back pain
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • 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.

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.

Code History & ChangesHistory

Replacement M54.59 replaces the following previously assigned code(s):

  • M54.5 - Low back pain
FY 2022AddedAdded to the ICD-10-CM code setEffective October 1, 2021.
FY 2023–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About M54.59Overview

Is M54.59 (Low back pain) a billable code?

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

What MS-DRG does M54.59 group to?

When other low back pain 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.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.