Is M54.12 a billable ICD-10-CM code?

Yes. M54.12 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does M54.12 sit in the tabular list?

Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other dorsopathies (M50-M54).

What cannot be coded together with M54.12?

M54.12 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M54.12 (M54.1, M54) and apply to it just the same.

M54.12

M54.12 — Radiculopathy, cervical region

Billable / specific codeICD-10-CM

M54.12 is a billable, specific ICD-10-CM code for radiculopathy, cervical region. It is valid for submission on a claim.

Excludes1 inherited from the categories above M54.12

These are not written on M54.12, but they bind it: a note on a category applies to every code beneath it. Billing M54.12 with anything listed here is a denial.

Written on M54.1 — Radiculopathy

neuralgia and neuritis NOS (M79.2)
radiculopathy with cervical disc disorder (M50.1)
radiculopathy with lumbar and other intervertebral disc disorder (M51.1-)
radiculopathy with spondylosis (M47.2-)

Written on M54 — Dorsalgia

psychogenic dorsalgia (F45.41)

Other codes that can never be billed with M54.12

These codes carry an Excludes1 note pointing at M54.12. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M54.12 alone.

G55Nerve root and plexus compressions in diseases classified elsewhere
R52Pain, unspecified

Risk adjustment

M54.12 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

M54.12 is named in 42 Medicare coverage policies — 35 listing it as supporting medical necessity, and 7 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
A58883Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
A58893Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered

How M54.12 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to M54.12.

Radiculopathy›cervical region

The condition this code belongs to

Every code for the condition on one page, which one applies when, and the mistake coders make with it.

Low back pain ICD-10 codes

Code history

M54.12 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share M54.1. If M54.12 is not quite right, the correct code is usually one of these.

Questions about M54.12

Is M54.12 a billable ICD-10-CM code?: Yes. M54.12 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does M54.12 sit in the tabular list?: Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other dorsopathies (M50-M54).
What cannot be coded together with M54.12?: M54.12 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above M54.12 (M54.1, M54) and apply to it just the same.