M54.59
M54.59: Other low back pain
Billable / specific codeICD-10-CM
M54.59 is a billable, specific ICD-10-CM code for other low back pain. It is valid for submission on a claim.
Check M54.59 with the rest of the claim: free scrubberExcludes1 inherited from the categories above M54.59
A category’s note binds every code beneath it.
Written on M54.5: Low back pain
Other codes that can never be billed with M54.59
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
M54.59 is named in 29 Medicare coverage policies: 16 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
- Pain›low back›specified NEC
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.