M54.1 – Radiculopathy

What is M54.1 – Radiculopathy code?

M54.1 is a general ICD-10-CM diagnosis code used to describe radiculopathy, a condition involving nerve root irritation or compression along the spinal nerve root. This disorder is typically marked by radicular pain, sensory loss referable to a specific body region, or weakness in the muscles served by the structures innervated by the involved nerve.

As of the 2025 ICD-10-CM coding guidelines, M54.1 is now non-billable for reimbursement purposes due to its lack of specificity. Providers must instead use more detailed subcodes that indicate the exact site of the radiculopathy or involved nerve root.

• M54.10 – Radiculopathy, site unspecified
• M54.11 – Radiculopathy, occipito-atlanto-axial region
• M54.12 – Radiculopathy, cervical region
• M54.16 – Radiculopathy, lumbar region
• M54.17 – Radiculopathy, lumbosacral region
• M54.18 – Radiculopathy, sacral and sacrococcygeal region

These specific, billable subcodes ensure accurate documentation and reimbursement for patient encounters involving radiculopathy.

Is M54.1 billable?

To ensure proper documentation and billing, use the following specific and billable diagnosis codes in place of M54.1:

• M54.10 – Radiculopathy, site unspecified
• M54.11 – Radiculopathy, occipito-atlanto-axial region
• M54.12 – Radiculopathy, cervical region
• M54.16 – Radiculopathy, lumbar region
• M54.17 – Radiculopathy, lumbosacral region
• M54.18 – Radiculopathy, sacral and sacrococcygeal region

These codes are essential for insurance claims, reimbursement purposes, and EHR documentation.

Clinical information

Radiculopathy is part of the broader musculoskeletal system disorders and often results from compression-related conditions like:

• Intervertebral disc disorder (especially disc herniation)
• Cervical disc degeneration
• Lumbar and other intervertebral disc displacement
• Cervical disc disorder with myelopathy
• Trauma or lesions affecting the thoracic spine or connective tissue

Common clinical manifestations include pain, sensory loss, tingling, and muscle weakness along the affected spinal nerve root. Diagnostic confirmation often requires imaging such as MRI or CT scans to assess the intervertebral disc and nerve root involvement.

Treatment for radiculopathy or neuritis or radiculitis varies based on the region involved (e.g., cervical region, thoracolumbar region, or thoracic region) and the severity of symptoms. Approaches include:

• Conservative care: rest, NSAIDs, and physical therapy
• Epidural steroid injections: to reduce inflammation around the involved nerve root
• Surgical options: Optoins such as discectomy or spinal decompression, for persistent or worsening symptoms

Synonyms include

Radiculopathy may also be coded or described under terms such as:

• Nerve root disorder
• Pinched nerve
• Radiculopathy brachial radiculitis NOS
• Radiculitis NOS lumbosacral neuritis
• Radiculitis NOS thoracic neuritis
• Neuralgia and neuritis NOS
• Brachial neuritis
• Neuritis NOS
• Psychogenic dorsalgia
• Back pain and low back pain

Other ICD-10 Codes commonly used for radiculopathy

• M50.00 – Cervical disc disorder with myelopathy, unspecified region
• M50.30 – Cervical disc degeneration, unspecified cervical region
• M99.03 – Segmental and somatic dysfunction of the lumbar region
• M54.5 – Low back pain, often seen as a symptom of lumbar radiculopathy
• M54.2 – Cervicalgia, related to neck pain and possible nerve root involvement