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M54.3

M54.3: Sciatica

Non-billable headerICD-10-CM

M54.3 is a non-billable header ICD-10-CM code for sciatica. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

  • intervertebral disc degeneration, lumbar region with lower extremity pain only (M51.361)
  • intervertebral disc degeneration, lumbosacral region with lower extremity pain only (M51.371)
  • lesion of sciatic nerve (G57.0)
  • sciatica due to intervertebral disc disorder (M51.1-)
  • sciatica with lumbago (M54.4-)

Excludes1 inherited from the categories above M54.3

A category’s note binds every code beneath it.

Written on M54: Dorsalgia

  • psychogenic dorsalgia (F45.41)

Other codes that can never be billed with M54.3

Their own Excludes1 notes name this code, so the conflict is not listed above.

  • G55Nerve root and plexus compressions in diseases classified elsewhere
  • G57.0Lesion of sciatic nerve
  • M51.1Thoracic, thoracolumbar and lumbosacral intervertebral disc disorders with radiculopathy
  • M79.2Neuralgia and neuritis, unspecified
  • R52Pain, unspecified

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

The condition this code belongs to

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead M54.3

3 child codes. Green means billable.

Other codes under M54

ICD-10-CMFY2027· effective October 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release: see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.