2026 ICD-10-CM Diagnosis Code M54.81Occipital neuralgia

ICD-10-CM Codes›M00–M99›M50-M54›M54

ICD-10-CM M54.81
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

M54.81 is a billable ICD-10-CM diagnosis code for occipital neuralgia. 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 cervico-occipital neuralgia. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Musculoskeletal pain, not low back pain.

Code Identity

ICD-10-CM Code
M54.81
Billable Status
Yes — Valid for Submission
Code Describes
Occipital neuralgia
Short Description
Occipital neuralgia
Same as the full description in the CMS dataset.
Parent Code
M54.8
Other dorsalgia

Code Classification

ChapterM00–M99Diseases of the musculoskeletal system and connective tissue
SectionM50-M54Other dorsopathies
CategoryM54Dorsalgia
This CodeM54.81Occipital neuralgia

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Cervico-occipital neuralgia

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.

    • Neuralgia, neuralgic(acute)
      • occipital

Clinical ClassificationClinical

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

CCSR MUS010
Musculoskeletal pain, not low back pain
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Headache

Almost everyone has had a headache. Headache is the most common form of pain. It's a major reason people miss days at work or school or visit the doctor.

Read the full article at MedlinePlus

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

Convert M54.81 to ICD-9-CMHistory

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

ICD-9-CM
723.8 Cervical syndrome NEC
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 M54.81Overview

Is M54.81 (Other dorsalgia) a billable code?

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

What MS-DRG does M54.81 group to?

When occipital neuralgia 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 M54.81?

Under the General Equivalence Mappings, occipital neuralgia converts to ICD-9-CM 723.8 (cervical syndrome NEC). 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.