M54.50
M54.50: Low back pain, unspecified
Billable / specific codeICD-10-CM
M54.50 is a billable, specific ICD-10-CM code for low back pain, unspecified. It is valid for submission on a claim.
Check M54.50 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Loin pain
- Lumbago NOS
Excludes1 inherited from the categories above M54.50
A category’s note binds every code beneath it.
Written on M54.5: Low back pain
Other codes that can never be billed with M54.50
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
M54.50 is named in 22 Medicare coverage policies: 9 listing it as supporting medical necessity, and 13 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A57497Billing and Coding: Chest X-Ray Policynot covered
- A57701Billing and Coding: Trigger Point Injections (TPI)not covered
- 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
Alphabetic index entries that lead here
- Lumbago, lumbalgia
- Low›back syndrome
- Pain›loin
- Pain›low back
- Pain›lumbar region
- Pain›spine›low back
- Syndrome›low›back
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.