M54.5 Low Back Pain Code Deleted

As of October 1, 2021, M54.5 (Low Back Pain) is no longer a valid diagnosis code. It has been replaced by more specific codes. This means that all your existing patients with a M54.5 diagnosis must be updated.

The new valid codes are as follows:

M54.50  Low back pain, unspecified
M54.51  Vertebrogenic low back pain
M54.59  Other low back pain

For the most part, M54.5 can be replaced by M54.51 provided that the cause of the LBP is of vertebral origin.

For Medicare M54.5 was a valid condition that supports medical necessity. We assume that the new M54.5X diagnoses will still be valid but the if and when have not been determined.

Using unspecified (M54.40) and other (M54.59) codes, especially as the first diagnosis, can generate requests for additional information.

Instructions for the FormSmith Software Program

To add, delete and edit ICD-10 codes click File | ICD-10 Diagnoses

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