Back Pain ICD 10

Back Pain ICD 10 & 11 (2022 Updated)

Are you looking for Back Pain ICD 10 & 11 Codes? This article includes all the medical codes you will need to report Back Pain, as well as other related specific ICD 10 codes such as Bilateral Chronic Back Pain and Back Pain with Sciatica. Read on for a summary of the necessary ICD 10 & 11 codes followed by a further description.

What Is Back Pain?

The most common symptom of back pain is an ache in the back and it can radiate to the legs or buttocks. Even the pain associated with a back problem can affect other areas of the body. The symptoms of a back disorder can vary from person to person. Some people experience chronic pain, while others only experience minor aches and discomforts. After a physical examination and questioning about symptoms, a diagnosis and treatment can correctly be established.

ICD 10 & 11 Codes For Back Pain

This article covers the following ICD 10 & 11 codes.

ICD 10 Codes For Back Pain

  • M54 – Dorsalgia
  • M54.9 – Dorsalgia, unspecified
  • G89 – Pain, not elsewhere classified
  • G89.29 – Other chronic pain
  • M54.10 – Radiculopathy, site unspecified
  • M54.30 – Sciatica, unspecified side
  • M54.31 – Sciatica, right side
  • M54.32 – Sciatica, left side
  • Z87 – Personal history of other diseases and conditions
  • Z87.39 – Personal history of other diseases of the musculoskeletal system and connective tissue
  • M79 – Other soft tissue disorders, not elsewhere classified
  • M79.10 – Myalgia, multiple sites
  • M54.6 – Pain in thoracic spine
  • M54.89 – Other dorsalgia
  • W19.XXXA – Unspecified fall, initial encounter
  • M54.1 – Radiculopathy
  • M54.4 – Lumbago with sciatica
  • O26 – Maternal care for other conditions predominantly related to pregnancy
  • O99 – Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium
  • O99.891 – Other specified diseases and conditions complicating pregnancy
  • M54.5 – Low back pain
  • O26.8 – Other specified pregnancy related conditions
  • O26.893 – Other specified pregnancy related conditions, third trimester
  • M54.16 – Radiculopathy

ICD 11 Codes For Back Pain

  • JA65 – Pregnancy dermatoses
  • JA65.Y – Back pain in pregnancy
  • ME84.3 – Sciatica
  • ME84.2Z – Low back pain, unspecified
  • 8B93.Z – Radiculopathy
  • ME84.2Y – Other specified low back pain
  • ME84.1 – Thoracic spine pain
  • ME86 – Symptom or complaint of a body part
  • ME86.2Z – Symptom or complaint of the back, unspecified
  • ME84 – Low back pain, unspecified
  • ME84.Z – Spinal pain, unspecified

Back Pain ICD 10

Back Pain ICD 10 code is M54.9. New ICD 10 codes for different types of back pain are more specific and there are new additions in subcategories in the musculoskeletal chapter.

While looking for pain/back in the alphabetic index and checking all the codes under the dorsalgia “M54” category, all of the other codes are specified with different terms except M54.9 “dorsalgia, unspecified”, Back pain with NEC rule is present as inclusion terms under this coder.

ICD 10 Code For Back Pain Unspecified

Whether back pain is unspecified or not otherwise classified, both conditions are used alternatively in the ICD 10 coding system, The ICD 10 Code For Back Pain Unspecified is M54.9.

Back Pain ICD 11 Code

Back pain falls under the stem code of “spinal pain” in the ICD 11 system, It is named as back pain NOS and pain in the back as inclusion terms under the main category “ME84”. The Back Pain ICD 11 code is ME84.Z.                                                             

icd 10 code for back pain

How To Code Chronic Back Pain

The following information is written to help you to determine how to code Chronic Back Pain.

What Is Chronic Back Pain?

When back pain results from injury, degenerative disc disorder, or any other disease and takes more than 12-14 weeks, it’s called chronic. Normally chronic back pain lasts more than 6 months and requires a different mode of treatment options to rectify the condition. The situation may not be completely resolved but reducing down the symptoms can determine the efficacy of pain medicine practice.

Chronic Back Pain ICD 10

he Chronic Back Pain ICD 10 is G89.29 and M54.9. Back pain is simply coded as “M54.9” and for chronic pain; the G89 category should be used. Under the G89 category, M54.9 falls under exclude 2 of ICD-10 conventions. It means that any condition coded under G89 is not classified to M54.9 and both conditions can be coded together.

ICD 10 Code For Chronic Back Pain Unspecified

Chronic back without any specified severity or specified term is always coded with unspecified code. The ICD 10 Code For Chronic Back Pain Unspecified is G89.29 and M54.9.

Acute On Chronic Back Pain ICD 10 Code

The acute on chronic back pain ICD 10 code is G89.29 and M54.9. Acute on chronic is not a term that is used for back pain, if the pain lasts lesser than 3 months, then it acute and If that back pain lasts longer than 3 months then it’s chronic.

Chronic Bilateral Back Pain ICD 10 Code

The Chronic Bilateral Back Pain ICD 10 code is G89.29 and M54.9. Literality is not defined for back pain whether it is acute pain or chronic pain, use the same combination while coding this condition.

Chronic Back Pain With Radiculopathy ICD 10 Code

The chronic back pain with radiculopathy ICD 10 code is G89.29 and M54.10 (in case of the unspecified region). Acute back pain is an integral component of radiculopathy but chronic back pain can be coded with radiculopathy to show the severity of the condition.

Chronic Back Pain With Sciatica ICD 10 Code

The Chronic Back Pain With Sciatica ICD 10 code is G89.29 and M54.30. Sciatica is coded by literality of nerve root that is affected if defined, back pain should not be coded as per exclude notes. If the right or left side of sciatica is defined, use M54.31 or M54.32.

History Of Chronic Back Pain ICD 10 Code

History of a medical condition means that a disease exited in past has been treated and no longer active treatment is required. History has a separate chapter in the ICD 10 coding system; code for back pain history can be identified by the following sequence in the alphabetic index as history/pain/back/chronic and trying to find specific code under the Z87 category. A specific code is unavailable; choose Z87.39 for the history of other disorders of the musculoskeletal system.

Acute Exacerbation Of Chronic Back Pain ICD 10 Code

No separate code is available in current addition to describe the severity “acute exacerbation” same combination of ICD 10 code G89.29 and M54.9 are used for acute exacerbation of chronic back pain.

Bilateral Chronic Back Pain ICD 10 Code

Right/left/bilateral is not specified for back pain in the ICD 10 coding system, right coding for bilateral chronic back pain is G89.29 and M54.9.

Chronic Back Pain ICD 11 

The chronic back pain ICD 11 code is ME86.2Z. In the ICD 11 system, WHO has classified chronic pain into two separate categories of primary and secondary medical terms! Currently, stem code for only primary chronic pain is provided and has been defined accordingly by WHO. The other category that we have currently is ME86 “symptom and complaint of the musculoskeletal system” and chronic back pain NOS is included under this term, the complete ICD 11 code for chronic back pain is “ME86.2Z”.

icd 10 code for low back pain

How To Code Upper Back Pain

The following information is written to help you to determine how to code Upper Back Pain.

What Is Upper Back Pain?

Upper back pain is usually caused by muscles and tendon ruptures, sometimes because of soft tissue injuries in the neck and cervical area. People of young ages get this problem from poor posture and sitting positions. Medications and changes in lifestyle can easily reduce and even revert the symptoms.

Upper Back Muscle Pain ICD 10 Code

Upper back pain and muscle pain are two different conditions according to the ICD-10 system. If both conditions co-exist, a code from category M79 for muscle pain and another code from the M54 category for back pain should be used. The code from upper back muscle pain would be M79.10 (myalgia) and M54.9.

Right Upper Back Pain ICD 10 Code

Lower back pain has specified code in the ICD 10 coding system but the upper back should be defined by region and no specific code is available either to describe the condition. Going through the alphabetic index as pain/back/upper, it will advise using M54.9. Therefore, The ICD 10 code for upper back pain is M54.9.

ICD 10 Code For Left Upper Back Pain

Right/Left is not described by any code currently by ICD 10, only code for back pain instead. If medical notes state this condition, the ICD 10 code For Left Upper Back Pain is M54.9.

ICD 10 Upper Back Pain Unspecified

The ICD 10 Upper Back Pain Unspecified code is M54.9. Upper back pain is already an unspecified term when no other manifestation, causes, or combination is available.

Acute Upper Back Pain ICD 10 Code

Currently, there is no code that can define acute upper back pain; acute is considered part of back pain unless it is chronic. One code for back pain is enough to describe the whole condition. The Acute Upper Back Pain ICD 10 code is M54.9.

Chronic Upper Back Pain ICD 10 Code

The Chronic Upper Back Pain ICD 10 code 29 and M54.9. Whenever a condition is mentioned as chronic, the main code category should be addressed first to see if it is defining the term “chronic” under it or not. If yes, only code from that category would be enough and if not, a code G89 for chronic pain and other code from the main category of disease should be used.

Bilateral Upper Back Pain ICD 10 Code

The Bilateral Upper Back Pain ICD 10 code is M54.9. A code for only the back pain is available currently, if the pain is defined as right/left/bilateral, only back pain should be coded in that case.

Upper Back Pain ICD 11 Code

The Upper Back Pain ICD 11 code is ME84.Z. WHO has not defined “upper back pain” as a separate classified medical term in the ICD-11 coding system. The same category of spinal pain should be used to report this condition.

How To Code Thoracic Back Pain

The following information is written to help you to determine how to code Thoracic Back Pain.

What Is Thoracic Back Pain?

Thoracic pain is another form of myofascial upper back pain that happens in the thoracic region. Thoracic present under the cervical, any abnormality, injury, and disease can be the reason for thoracic pain. The cause of pain defines the type of pain in the thoracic region. Usually, a pressing and dull pain under the shoulder of the blade can be felt through the T1-T7 process.

Thoracic Back Pain ICD 11 Code

The Thoracic Back Pain ICD 11 code is ME84.1 with any other extension code for the reason of pain. In ICD 11 system, thoracic pain is coded under the ME84 category as same as other spinal pains. Writing down “thoracic pain” in ICD 11 coding tool and pressing the search button will provide the main stem code with other extensions (for a reason and the cause of the pain) that will also emerge.

Thoracic Back Pain ICD 10 Code

There is only one code for acute, bilateral, specified, and unspecified thoracic pain in the ICD 10 coding system. While looking for the alphabetic index for pain/thoracic, it will lead to the M54.6 subcategory that is also working as a complete code, the thoracic back pain ICD 10 code is M54.6.

Acute Thoracic Back Pain ICD 10 Code

The Acute Thoracic Back Pain ICD 10 code is M54.6. If any pain in the back is described as acute, there is no need to use a separate code neither available. “Acute” term is already present as inclusive under thoracic back pain.

chronic back pain icd 10

Chronic Right Sided Thoracic Back Pain ICD 10

The Chronic Right Sided Thoracic Back Pain ICD 10 code is G89.29 and M54.6. Literality is never defined for back pain except in the case of sciatica, use a coded form G89 category and the other code from M54.

Acute Nontraumatic Thoracic Back Pain ICD 10

The Acute Nontraumatic Thoracic Back Pain ICD 10 code is M54.6. A pain that is not related to a traumatic injury is called non-traumatic pain; it can be due to excessive exercise or some other medical condition. M54.6 is actually the code for non-traumatic pain; pain is not coded when a trauma of the thoracic region is specified.

Left Sided Thoracic Back Pain ICD 10 Code

The Left Sided Thoracic Back Pain ICD 10 code is M54.6. The left side of thoracic pain does not have to be coded with a separate code; the same code for thoracic pain should be used.

How To Code Mid Back Pain

The following information is written to help you to determine how to code Mid Back Pain.

What Is Mid Back Pain?

Mid back pain refers to the discomfort in the area around the thoracic spine or thoracolumbar region. The region is mostly confined from rib to mid back. Any injury to muscles, ligaments, vertebral discs, or joints can cause mid back pain that ranges from acute to chronic.

Mid Back Pain ICD 10

The Mid Back Pain ICD 10 code is M54.89. There are two options to code mid back pain and both would be correct when billing a claim. Using M54.9 as back pain NOS is one option, the other more appropriate option would be using a code for other specified back pains.

Right Mid Back Pain ICD 10

The Right Mid Back Pain ICD 10 code is M54.89. Other specified codes will be a more appropriate code to bill in this case, as there is no specified code available to show literality nor for mid back pain.

Left Mid Back Pain ICD 10

The Left Mid Back Pain ICD 10 code is M54.89. If a medical document contains assessment as “left/right/bilateral side mid back pain”, NEC code from the M54 category would be appropriate code for all of this diagnosis.

Fall Cause Mid Back Pain ICD 10 Code

The Fall Cause Mid Back Pain ICD 10 code is M54.89 and W19.XXXA.

When a patient fall results in an injury, a code for injury and other code from the cause of injury is used. When the injury is specified and pain of the same area is documented, should use only code for injury. However, sometimes, injury or fracture does not happen from a fall/not documented at first encounter or patient feels pain after sometime of fall.

In that case, a code from pain (when the injury is not specified in assessment) and others from falls would be appropriate to code. While looking for the alphabetic index for “fall” that will lead you to one unspecified category W19.

Chronic Mid Back Pain ICD 10 Code

The Chronic Mid Back Pain ICD 10 code is G89.29 and M54.89. One code from chronic pain category G89 and the other from M54 should be used for chronic mid back pain.

Mid Back Pain ICD 11 Code

Same as the ICD 10 system, it would be appropriate to use a code from other specified pain categories. While searching for back pain in ICD 11 coding tool and scrolling down to look at stem code for application of NEC rule. According to this rule, the ICD 11 code for mid-back pain is ME84.2Y.

icd 10 code for chronic back pain

How To Code Mechanical Back Pain

The following information is written to help you to determine how to code Mechanical Back Pain.

What Is Mechanical Back Pain?

Mechanical pain can be defined as any general type of back pain that radiates from your back to buttocks and thighs with spasms. One can feel strain and stress when doing flexion or lifting and walking with an object. Generally, muscles are most affected during mechanical pain and different types of treatments are targeted at the site of mechanical pain.

Mechanical Back Pain ICD 10 Code

No separate subcategory for mechanical pain is present in the ICD 10 coding system. If a region is specified, use code that is specific to the region, like M54.6 for mechanical thoracic pain. If regions are not specified, as in the main description, the Mechanical Back Pain ICD 10 code is M54.89.

Chronic Mechanical Back Pain ICD 10

One code for chronic pain “G89.29” and the other from M54.89 are used to describe the chronic mechanical pain of unspecified back region. 

Mechanical Back Pain ICD 11 Code

The main stem code “ME84” that is used for spinal pain should be used for mechanical back pain as no other category or code is available for mechanical or other specified back pain. The Mechanical Back Pain ICD 11 code is “ME84.Z” with other manifestation codes if any desired. 

How To Code Left Back Pain

The following information is written to help you to determine how to code Left Back Pain.

What Is Left Back Pain?

Back pain is discomfort or aches in any spinal area that can be on the right or left side of the spine. There can be an injury, herniated disc, or spasm on the left side of the spine and but treatment can be on both sides of the body. An x-ray or CT scan would be enough to see if there is herniation or injury on the left part of the spine.

Left Back Pain ICD 10 Code

The left back pain ICD 10 code is M54.9. No literality is currently present for back pain; the only code that should be used is “back pain”.

Back Pain With Left Side Radiculopathy ICD 10 Code

Back pain is not coded with radiculopathy as its integral part of this main disease. Radiculopathy subcategory “M54.1” has code for all spinal regions but no literality is defined currently with any of those codes. The ICD 10 code for the unspecified region of radiculopathy is M54.10.

Acute Left Sided Back Pain With Sciatica ICD 10

When coding sciatica with low back pain, a combination code from the M54.4 subcategory is used to describe both conditions but the ICD-10 coding system has not provided a combination code for the back pain with sciatica. In this case, a code from sciatica and other code for back pain should be used. ICD 10 code M54.32 for the left side of sciatica and M54.9 for back pain, both should be used in this condition.

ICD 11 Code For Left Sided Back Pain

Searching the “left side back pain” in ICD 11 coding tool will provide no matching codes because of the unavailability of literality for back pain, should be Using the same code that is used for spinal pain. The ICD 11 code for left-sided back pain is ME84.Z.                                                

upper back pain icd 10

How To Code Right Back Pain

The following information is written to help you to determine how to code Right Back Pain.

What Is Right Back Pain?

Acute back pain whether on the left or right side comes on suddenly and mostly lasts from a few hours to a few weeks. The reason for right-sided pain can be a muscle strain or spinal injury on the right side of the spinal column. Mostly rest with medication is prescribed to treat the condition but rest of more than 3-4 days can also deteriorate the condition, so light exercise is usually recommended during treatment.

ICD 10 Code For Right Back Pain

The ICD 10 code for right back pain is M54.9. Only a code for back pain as unspecified should be used in that case, no literality is currently updated in new modifications.

ICD 10 Code For Right Upper Back Pain

The ICD 10 code For Right Upper Back Pain is M54.9. Only a code from back pain would be sufficient to code the condition as no such specified code for right or upper back is available in the current ICD 10 system.

Right Back Pain ICD 11 Code

When ICD 11 coding was present, it was designed in such a way that future literality modifications can easily be included, until the right/left side of back pain is assigned with some extension code, ICD 11 code for right back pain is ME84.Z.

How To Code Muscular Back Pain

The following information is written to help you to determine how to code Muscular Back Pain.

What Is Muscular Back Pain?

Soft tissues, tendons, ligaments are muscles play a key role in muscular pain. Ligament strain, muscle stress, or tear with soft tissue injuries are the main causes of muscular back pain. Mostly over-the-counter drugs and ice packs are prescribed for this type of pain and usually, this kind of pain takes a few weeks to resolve if injury or tear is not much severe.

Muscular Back Pain ICD 10 Code

The Muscular Back Pain ICD 10 code is M54.9. Back pain is mostly caused by muscle strain or other spinal injuries. Describing pain in the back already covers the fact that pain can be the result of muscles, soft tissue, ligaments, or spinal injury or pain. Only use M54.9 in that case of muscular back pain. If the term “back” is not described then the only code will be M79.10.

Left Back Muscular Pain ICD 10

There is no separate code for the right or left side of muscular pain available, only a code for the back pan should be used, the ICD 10 code for the right/left side of muscular back pain is M54.9.

Right Back Muscular Pain ICD 10

There is no separate code for the right or left side of muscular pain available, only a code for the back pan should be used, the ICD 10 code for the right/left side of muscular back pain is M54.9.

Muscular Back Pain ICD 11 Code

ME84 category accurately defines spinal pain and back pain NOS but there is a different category for muscular pain that cannot use with back pain because of exclusion notes. The ICD 11 code for the muscular back is ME84.Z.

How To Code Back Pain With Radiculopathy

The following information is written to help you to determine how to code Back Pain with Radiculopathy.

What Is Back Pain With Radiculopathy?

Radiculopathy can be defined as inflammation, irritation injury, or compression of a nerve root in the spinal area. Burning and stinging pain is one of the main symptoms of radiculopathy. Pain often radiates from the upper back region to the hips and is mostly treated by anti-inflammatory drugs, physical therapy, and muscle relaxants. In the case of herniated nerve compression, surgery is required to treat the condition.

Back Pain With Radiculopathy ICD 10 Code

Back pain is an integral part of radiculopathy, it should not be coded separately especially in hospital and home care settings where several diagnoses provide an estimate of the treatment cost.

Looking at the main term radiculopathy in the alphabetic index will lead to category M54.1; should choose the specific code depending on the region of radiculopathy. If the region is not specified, the appropriate ICD 10 code for back pain with radiculopathy is M54.10.

Back Pain With Right/Left Radiculopathy ICD 10 Code

Radiculopathy codes are currently based only on the affected region, there is no code describing the right or left side of the condition. Only one code should be used that is related to the region, the ICD 10 code for back pain with right/left radiculopathy is M54.10 (in case of the unspecified spinal column).

Back Pain With Radiculopathy ICD 11 Code

Looking for the term “radiculopathy” in ICD 11 coding tool will provide a list of all stem codes with different manifestations, causes, and combinations. The choice of stem code, in absence of any specification, is 8B93.Z. In exclusion terms; it is advised not to code back pain with radiculopathy. If there is any condition associated with radiculopathy, code with an extension and if not, then ICD 11 code for back pain with radiculopathy is 8B93.Z.

icd 10 code for back pain unspecified

How To Code Back Pain In Pregnancy

The following information is written to help you to determine how to code Back Pain in Pregnancy.

What Is Back Pain In Pregnancy?

During pregnancy, ligaments, muscles, and joints become relaxed because of the release of relaxin hormone in the pregnant woman’s body. This condition puts extra stress on the muscles and joints in the back area of a woman causing different types of upper and lower back pain. It is advised to use specific methods to do daily living activities during pregnancy as medications and other modes of treatments are not appreciated.

Back Pain In Pregnancy ICD 10 Code

The Back Pain In Pregnancy ICD 10 should be coded as O99.891 and M54.9.

Pregnancy code ranges from (O00-O99), always use one code from this category before using any other code for other conditions. Looking for pain/back/pregnancy or main term “pregnancy” and finding back pain will provide a list of other specified codes.

There are two ways to code the back pain, either the condition has arisen because of pregnancy, category O26 is recommended or a condition already present is complicating the pregnancy, category O99 is recommended in that case.

Lower Back Pain In Pregnancy ICD 10 Code

A code for “other specified conditions complicating the pregnancy” should be used with one code for lower back pain. The ICD 10 code for lower back pain in pregnancy should be coded as O99.891 with M54.5 for lower back pain to show the secondary condition.

Chronic Back Pain In Pregnancy ICD 10 Code

The Chronic Back Pain In Pregnancy ICD 10 code is O99.891, G89.29, and M54.9. O99.891 should be used for the pregnancy-related condition with a combination of codes to show that back pain is chronic. The primary code will be O99.891 with G89.29 and M54.9.

Severe Back Pain In Pregnancy Third Trimester ICD 10 Code

The severe back pain in pregnancy third trimester ICD 10 code is O26.893 and M54.9. If a back is complicating the pregnancy, category O99 should be used but if back pain originates because of pregnancy, then a code from O26 should be used to show that it’s a pregnancy-related condition. Under the subcategory of O26.8, a code for a specific trimester can be found.

Thoracic Back Pain In Pregnancy ICD 10 Code

One code from either O26 or O99 with one code for thoracic pain should be used to completely describe the condition. Use O99.891 if thoracic pain causes complications in pregnancy. If thoracic pain is a pregnancy-related condition, the Thoracic Back Pain In Pregnancy ICD 10 code is O26.899 (as trimester is not defined) with M54.6.

Upper Back Pain In Pregnancy ICD 10 Code

Back pain has not had a separate code in the ICD 10 coding system when defined as upper, the Upper Back Pain In Pregnancy ICD 10 code is O26.899 with M54.9.

Back Pain In Pregnancy ICD 11 Code

Currently, the Back Pain In Pregnancy ICD 11 code is JA65.Y. The Current ICD 11 system needs to be updated a lot for a pregnancy-related condition with more specific terms. By typing “pregnancy” in the search engine of coding tool and choosing pregnancy-related conditions present under the main term, the only stem code that is more appropriate JA65.

How To Code Back Pain With Sciatica

The following information is written to help you to determine how to code Back Pain with Sciatica.

What Is Back Pain With Sciatica?

Sciatica is pain that is caused by compression, injury, or irritation of nerve radiating to both sides of the back resulting in pain in supplied regions. Radiological tests are important in determining the severity of injury and back pain is mostly associated with sciatica.

Back Pain With Sciatica ICD 10 Code

The Back Pain With Sciatica ICD 10 code is M54.30 and M54.9.

When sciatica is described with low back pain, a combination code is available to code the condition but there is no combination code for sciatica with back pain. The cause of Back pain can be different, should use M54.30 for unspecified sciatica, M54.31 for the right side, and M54.32 for the left side of sciatica.

Acute Back Pain With Sciatica Right ICD 10

The Acute Back Pain With Sciatica Right ICD 10 code, as discussed earlier, is M54.31, and the code for acute/upper/lower/severe back pain will always be M54.9. There are no exclusion notes under M54.3 for back pain; so, the Acute Back Pain With Sciatica Right ICD 10 code is M54.31 and M54.9.

Acute Back Pain With Sciatica Left ICD 10

Code for left side sciatica is M54.32 and for back pain is M54.9. As there is no separate code available for the acute term, the Acute Back Pain With Sciatica Left ICD 10 code is M54.32 and M54.9.

Back Pain With Sciatica ICD 11 Code

The Back Pain With Sciatica ICD 11 code is ME84.3, ME84.Z. Two codes from ICD 11 edition should be used for this condition. As sciatica is a more severe condition, search out sciatica in ICD 11 coding tool, ME84.3 is the main stem code for sciatica. A code for back pain should also be used for cluster coding.

thoracic back pain icd 10

How To Code Severe Back Pain

The following information is written to help you to determine how to code Severe Back Pain.

What Is Severe Back Pain?

When there is a sudden awkward change in physical posture and causes a tear in ligaments and muscles, it produces severe pain in the back area. Using ice packs and contained physical exercises with medication is the best mode of treatment for severe back pain.

Severe Back Pain ICD 10 Code

The Severe Back Pain ICD 10 code is M54.9. The severity of back pain is not described by a specified code, even though the severity is explained for other diseases in ICD 10 current edition. M54.9 would suffice the coding of severe back pain but sometimes providers choose the other specified code for this condition that is not appropriate.

Chronic Severe Back Pain ICD 10 Code

The Chronic Severe Back Pain ICD 10 code G89.29 and M54.9. Searching for chronic pain in the alphabetic index (as it is the main primary code to describe the severity, and then other code M54.9 for severe back pain should be used. The ICD 10 code for chronic severe pain is G89.29 and M54.9.

Severe And Progressive Back Pain ICD 10 Code

Same code M54.9 should be used for severe and progressive back pain, as no other specified code is available currently in the ICD 10 system.

ICD 10 Code For Severe Intractable Back Pain

The ICD 10 code For Severe Intractable Back Pain is M54.89. As explained earlier, Intractable back pain is coded as M54.89 and no specified code for the severity of pain is available for the back area.

Severe Back Pain ICD 11 Code

The Severe Back Pain ICD 11 code is ME84.Z. It should be used for severe back pain, the terms Acute, severe, and sudden back pain are present as inclusion terms in the ICD 10 coding system.

How To Code Lumbar Back Pain

The following information is written to help you to determine how to code Lumbar Back Pain.

What Is Lumbar Back Pain?

The lumbar back is also known as Lumbago is one of the most common causes of hospital admissions in the US. In fact, every person gets this condition during some time in life. The pain is mostly confined to the lumbar region or may spread to other associated regions. The reason can be injury, diseases and bad posture and treatment include medications, surgery, and prosthesis.

Lumbar Back Pain ICD 10

The Lumbar Back Pain ICD 10 code is M54.50. Looking for the alphabetic index in the ICD 10 codebook will lead to the M54.5 subcategory, the first code is appropriately describing this condition.

Acute Lumbar Back Pain ICD 10 Code

Whether back pain is severe or acute, the same pain code should be used for every spinal area. One can find lumbago under M54.50; hence, The Acute Lumbar Back Pain ICD 10 code is M54.50.

ICD 10 Code For Lumbar Back Pain With Radiculopathy

The ICD 10 Code For Lumbar Back Pain With Radiculopathy is M54.10.

Radiculopathy deals with damage to the nerve of a specific spine area, most specifically; it can be described as lumbar, cervical, thoracic, and sacral radiculopathy. A radiculopathy is a group of symptoms of the spine area and it covers pain, itching, and other associated symptoms in it.

If a doctor provides an assessment of “Lumbar radiculopathy with pain”, only radiculopathy of the lumbar area “M54.16” should be coded. Most payers deny coding pain of the same spinal area as radiculopathy. If the spinal area for radiculopathy and pain is different, coding of both conditions is allowed separately.

Chronic Lumbar Back Pain ICD 10 Code

The Chronic Lumbar Back Pain ICD 10 code is G89.29 and M54.50. According to ICD-10 guidelines, if the pain is described as chronic, use one code from the G89 category and then one code from the area of actual pain. G89.29 should be used when the origin of the pain is unspecified.

If chronic pain is not specifically described as a result of trauma but trauma or injury is mentioned in history, G89.21 would still be appropriate. Use M54.50 as the secondary diagnosis.

Right Lumbar Back Pain ICD 10

The Right Lumbar Back Pain ICD 10 code is G89.29 and M54.50. No literality code is provided by the ICD 10 system, a further modification may provide new sets of code for the right and left side but currently, G89.29 and M54.50 are fulfilling the need of condition coding.

chronic low back pain icd 10

Left Lumbar Back Pain ICD 10

The Left Lumbar Back Pain ICD 10 code is G89.29 and M54.50. The same set of codes, G89.29 and M54.50, should be used for the left side of chronic lumbar back pain. Never use M54.59 “other specified low back pain” for literality, as literality does not fall under NEC coding rule.

ICD 10 Code For Acute Lumbar Back Pain

No specified code for the term “acute” when coding for lumbar back pain, Code M54.50 will accurately describe condition coding, no classification for severity is present currently in the ICD-10 system. For Acute lumbar back pain, use code M54.50 as an acute condition is covered under its description according to the ICD-10 system.

Remember, if a fracture or injury of the lumbar area has been confirmed, acute pain of the lumbar area should not be coded as pain is associated with fracture or injury of the same area. Most government and commercial payers will deny coding both conditions on the same claim. The ICD 10 code for acute lumbar back pain is M54.50.

Acute Nontraumatic Lumbar Back Pain ICD 10

The Acute Nontraumatic Lumbar Back Pain ICD 10 code is M54.50. The ICD M54.50 has the inclusion term “nontraumatic” under its description so the same code should be used when lumbar pain is described nontraumatic.  

Lumbar Back Pain ICD 11 Code

The Lumbar Back Pain ICD 11 code is ME84.2Z. Following the alphabetic index and then verifying the code in the tabular index, it will lead to ME84.2Z that states “Lumbar pain, unspecified”. This code falls under the acute pain category in ICD 11, there is a separate code available for chronic lower back pain. This kind of specificity is unavailable in the ICD 10 system.

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