M54.31
M54.31: Sciatica, right side
Billable / specific codeICD-10-CMright
M54.31 is a billable, specific ICD-10-CM code for sciatica, right side. It is valid for submission on a claim.
Check M54.31 with the rest of the claim: free scrubberExcludes1 inherited from the categories above M54.31
A category’s note binds every code beneath it.
Written on M54.3: Sciatica
Other codes that can never be billed with M54.31
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
M54.31 is named in 26 Medicare coverage policies: 19 listing it as supporting medical necessity, and 7 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- 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
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.