ICD 10 code lower back pain and its causes.

by Mouli Chakraborty
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Clinically lower back pain is one of the common back pain people face nowadays. It happens to all ages and every gender. As said by doctors the pain for lower back pain can be due to multiple reasons. And in this article, you will learn about the most probable causes. Other than that, the details about  ICD 10 code lower back pain will also be addressed. 

What is the ICD 10 code lower back pain? 

First, let’s begin with the ICD’s full form. ICD stands for International Statistical Classification of Disease and Related Health problems. At present, ICD is with its 10th revision of the classification, and all related codings are its result. The ICD 10 code lower back pain and other coded medical classification are primarily generated by the WHO which is also known as the World Health Organisation. The ICD 10 is used by medical personalities like physicians for a more systematic classification and also replaces the earlier ICD 9 classification. 

ICD 10 code for lower back pain
ICD-10-code-lower-back-pain-and-its-causes.

Unlike ICD 9 the ICD 10 is more detailed and medically advanced. It has more than seventy thousand new codes which are not present in the earlier medical classification. 

ICD 10 code lumbago and it’s correspondent ICD 9 code

In the coding language of ICD, both the 9 and 10 classifications have addressed lower back pain. The ICD 10 code lower back pain is billable M54.5. This particular code is applied by healthcare diagnosis for chronic lower back pain. The ICD 9 corresponding code for lower back pain is 724.2 The Lower Back Pain abbreviation is known as LBP. In medical terms, it is known as Lumbago

Also, read our article on Lower back pain before period: Types and Remedies

The ICD 10 code lower back pain with radiculopathy

The lumbar radiculopathy edition of M54 got affected from the year October 1, 2020. Medically radiculopathy lower back pain originates in the lower back and then it radiates through the spine. The ICD 10 code lower back pain with radiculopathy is applicable in the case of these five types of Non-Billable codes,-

  • In the case of radiculitis NOS is also known as Brachial Neuritis.
  • The radiculitis NOS or the other name for Lumbar Neuritis.
  • The Lumbosacral Neuritis.
  • Radiculitis NOS and
  • Thoracic Neuritis. 

Other than this the types it excludes are Neuritis NOs in the M79.2 code. And also excludes the Cervical disc disorder of the M50.1. 

What is the ICD 10 code for lower back pain in pregnancy?

Commonly, pregnancy is also the reason for lower back pain. The ICD 10 code lower back pain in pregnancy is a billable specific code, unlike radiculopathy codes. The specific code can be used for directing towards the diagnosis of reimbursement purposes. The pregnancy lumbar pain ICD code for pregnancy is 026.93 in America, this varies internationally. 

The 026.93 applicable regulations. 

The pregnancy 026.93 coding is applicable for patients fulfilling maternity conditions under the age group of 12-55years. (Both 12 and 55 are inclusive of it). The coding is also relevant for those patients who are in their third-trimester pregnancy. For your information, the third-trimester pregnancy consists of 28 weeks, which is calculated from the last menstrual week. There is no change in the ICD 10 code for history of lower back pain due to pregnancy since the year 2016. 

Nature of ICD 10 code for lower back pain with sciatica

The lower back pain with sciatica is generally the pain that originates from the lower back portion and goes down towards the leg. The pain is generated from the sciatic nerve. The ICD 10 code for lower back pain with sciatica is M54.4. However, the international coding for the same can vary. 

Nature of the M54.4.

Some of the common notable points about the M54.4 are as follows-

  • The coding is non-billable and is also referred to as nonspecific code. Along with that, it will not apply to the purposes of reimbursement. It is so because there are detailed coding’s available for lumbago with sciatica below M54.4. 
  • The 2021 version of ICD-10 M54.4 was effective from the year 2021, first October. 
  • And lastly, it excludes lumbago with sciatica pain caused due to intervertebral disc order. 

The symptoms for pain in the thoracic 

Thoracic pain is generally the pain between the bottom spine and the rib cage bottom. The ICD 10 code for upper and lower back pain corresponds to the thoracic pain ICD 10. The thoracic pain code is billable and therefore is specific. I got affected in the year 2020. 

The symptoms for pain in the thoracic 

Some of the possible symptoms for thoracic pain are as follows: 

  • Due to some thorax chronic pain.
  • Chronic back thoracic pain.
  • The presence of lumbar with the syndrome of Myofascial pain. 
  • The thoracic joint pain. 
  • The thoracic spine pain among types of syndrome. 

The ICD 10 code for lower back pain with spondylitis and its symptoms.

Generally, spondylitis is the normal tear of the lumbar spinal discs. In medical terminology, it is referred to in the names of lumbar spondylitis. The ICD 10 site cites lumbar spondylosis without radiculopathy or myelopathy in the M47.814 code. It is billable and includes certain symptoms like spondylitis along with thoracic joint pain. Thoracic spondylitis is also included in them. 

The clustering of M47.814 in The diagnostic-related group. 

The M47.814 have been grouped into two diagnostic related groups as Er the ICD 10 data from the website. The two groups are namely-

  • The clinical back issues along with MCC are given in 551 code.
  • The clinical back issues without MCC are given in the 552 code.

The ICD 10 for the history of lower back pain of M47.814 has remained unchanged since the year 2016. However, in 216 itself, a new code was introduced which has been followed since then. 

What are the approximate symptoms of the ICD 10 code for left lower back pain with sciatica?

The ICD code for the left side lumbar with sciatica is M54.42. The code is billable and specific to the diagnosis of reimbursement purposes. Common symptoms of M54.42 is the ICD 10 code for left lower back pain with sciatica are 

  • The co-occurrence of the lumbago pain along with bilateral sciatica. 
  • The presence of lumbago with left-side sciatica. 
  • The presence of lumbago with right-sided sciatica. 

The M54.42 is also the ICD 10 code for low back pain radiating to the left lower extremity. The pain can be due to musculoskeletal disease along with other connective tissue issues. The dorsalgia and dorsopathies are also the causes of left-sided lumbago pain. 

A brief on muscle strain with tendon on the lower back 

A brief on muscle strain with tendon on the lower back 

The muscle strain along with the tendon on the lower back is present in the S39.012A, ICD 10 code for muscle pain in the lower back. The common causes for muscle strain in the lower back portion can be due to any kind of sudden injury to the abdomen or the lower back portion. Related pain in the lumbar spine, pelvis or outer genitals can also cause muscle strain creating pain in the lower back. The two common symptoms for muscle strain with tendon on the lower back are lumbar muscle strain and other low back strain. 

Treatment for lower back pain

Overall, if you are also suffering from lower back pain then there are some ways to cure them. Some of them are by maintaining a good posture, keeping a proper diet plan, through physiotherapy, and not carrying bulky weights. 

Conclusion

Thus, there are diverse kinds of lower back pain and all of them have individual symptoms and it’s treatments. The ICD 10 lower back pain for the convenience of the physicians has systematically classified all of them along with the possible symptoms. It’s being updated each year along with the correspondent code associated with them. 

Frequently asked questions(FAQs):-

Q. What is the ICD-10 code for bilateral low back pain with sciatica?

Ans. The ICD code for bilateral low back pain along with sciatica is M54.4. The M54.4 code is non-billable and a non-specific code. 

Q. What is ICD-10 code M54?

Ans. The M54 ICD code 10 is related to low back pain and its possible types. In the M54 code, the symptoms associated with low back pain are also mentioned. 

Q. What is the ICD-10 code for Lumbalgia?

Ans.  The ICD code -10 for Lumbalgia is M54.54. The causes for lumbalgia can be due to disc replacement or other intervertebral problems. 

Q. What is the ICD-10 code for chronic pain?

Ans. The ICD 10 code for chronic pain is G84.4 which is billable and can also be used for indicating diagnosis for reimbursement. 

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