M54.50 – Low back pain, unspecified

M54.50 diagnosis code: Low back pain, unspecified 

• The M54.50 ICD 10 code denotes "Low back pain, unspecified."
• "Unspecified" means that while the patient is experiencing symptoms, the exact cause or nature of the condition is not yet determined. This can often be the case with back pain, as it can have a variety of causes, and the specific cause may not be immediately clear.
• M54.50 refers to pain experienced in the lumbar region, often without a known cause.
• It's a widespread issue affecting individuals of all age groups, but it is particularly prevalent in adults.
• The pain can vary from mild to severe and can be chronic or acute pain.
• This diagnosis doesn't attribute the pain to a specific underlying condition.
• M54.50 is often used at the beginning of treatment before establishing a more detailed diagnosis.

Is M54.50 billable?

Yes, M54.50 is a billable code. It specifies a medical diagnosis for reimbursement purposes. However, the code's applicability can depend on several factors, including the patient's condition and the medical provider's judgment.

Clinical information

• While "low back pain" is a relatively broad term, it refers to pain in the lower back area, roughly between the bottom of the rib cage and the top of the legs. It does not include hip pain, upper back pain, or neck pain.
• The patient may experience chronic pain (long-lasting). Meanwhile, acute low back pain is sudden and severe. It can range from a dull, constant ache to a sudden, sharp sensation that leaves the person incapacitated.
• Potential causes of localized pain in the lower back include muscle or ligament strain, disc problems, arthritis, skeletal irregularities, or osteoporosis. However, with the M54.50 code, these specific causes still need to be identified.
• A more specific code might be chosen once the clinician has gathered more information or if the patient's condition evolves.

Synonyms include

• Low back syndrome
• Lower back pain
• Chronic low back pain
• Lumbago
• Low back pain without sciatica
• Pain in lumbar region

Other ICD-10 codes commonly used for low back pain

• M48.06: Spinal stenosis, lumbar region
• M51.26: Other intervertebral disc displacement, lumbar region
• M51.27: Other intervertebral disc displacement, lumbosacral region
• M51.362: Other intervertebral disc degeneration, lumbar region with discogenic back pain and lower extremity pain
• M53.3: Sacrococcygeal disorders, not elsewhere classified
• M54.16: Radiculopathy, lumbar region
• M54.41: Lumbago with sciatica, right side
• M54.42: Lumbago with sciatica, left side
• M54.5: Low back pain
• M54.51: Vertebrogenic low back pain