Low back pain ICD-10 code
The ICD-10-CM code for low back pain is M54.50 (low back pain, unspecified). It is billable and valid for submission on a claim. There are 14 related codes, and which one you use depends on what the documentation supports.
Also written as lbp, lumbago, back pain.
The mistake coders make here
M54.5 alone is no longer valid: it was subdivided. M54.50 unspecified, M54.51 vertebrogenic, M54.59 other. Claims still submitted with plain M54.5 reject.
Putting low back pain on a claim? Check the claim’s diagnosis codes free: Excludes1 conflicts, header codes and missing seventh characters, before it goes out.
ICD-10-CM codes for low back pain
9 of 14 are billable. Green means you can submit it as-is.
| Code | Use it when |
|---|---|
| M54.50 | Low back pain, unspecified |
| M54.51 | Vertebrogenic low back pain |
| M54.59 | Other low back pain |
| M54.5 | Low back painnot billable on its own |
| M51.360 | Other intervertebral disc degeneration, lumbar region with discogenic back pain only |
| M51.369 | Other intervertebral disc degeneration, lumbar region without mention of lumbar back pain or lower extremity pain |
| M51.370 | Other intervertebral disc degeneration, lumbosacral region with discogenic back pain only |
| M51.379 | Other intervertebral disc degeneration, lumbosacral region without mention of lumbar back pain or lower extremity pain |
| M51.362 | Other intervertebral disc degeneration, lumbar region with discogenic back pain and lower extremity pain |
| M51.372 | Other intervertebral disc degeneration, lumbosacral region with discogenic back pain and lower extremity pain |
| M79.66 | Pain in lower legnot billable on its own |
| R10.A | Pain localized to flanknot billable on its own |
| R10.1 | Pain localized to upper abdomennot billable on its own |
| R10.3 | Pain localized to other parts of lower abdomennot billable on its own |
Once you have the code
- Check the whole claim: Excludes1 conflicts and missing seventh characters, free
- Denial codes explained: what CO-16, CO-97 and the rest actually mean
- Decision guides: walk a chart note to a code, guideline cited
- Everything here that is free, and the one thing no free tool includes
M54.5 became three codes in FY2022
M54.50 is low back pain unspecified, M54.51 is vertebrogenic low back pain (pain attributed to the vertebral endplates, typically documented after imaging shows Modic changes), and M54.59 is other low back pain: loin pain and lumbago NOS index here. M54.5 by itself has been invalid since 1 October 2021 and is a routine rejection reason on older templates. Sciatica without back pain is M54.3- (M54.30 unspecified side, M54.31 right, M54.32 left); lumbago with sciatica is M54.4- to the same laterality; and a documented lumbar radiculopathy is M54.16 (lumbosacral M54.17).
Once a cause is documented, the pain code comes off
Low back pain due to a documented disc disorder is coded to the disc disorder, not to M54.5-. Lumbar disc degeneration is M51.36-, which since FY2025 is reported to a sixth character by the pain pattern (M51.360 with discogenic back pain only, M51.361 with lower-extremity pain only, M51.362 with both, M51.369 without mention of either); lumbar disc herniation with radiculopathy is M51.16; spinal stenosis of the lumbar region is M48.06- (M48.061 without, M48.062 with neurogenic claudication); spondylolisthesis is M43.16. A lumbar strain is an injury: S39.012A for the initial encounter, with the external cause codes.
Chronic pain, and what 'back pain' alone supports
Chronic low back pain documented as such is G89.29 (other chronic pain) in addition to the site code, and the G89 code is sequenced first when the encounter is for the pain management itself (Guideline I.C.6.b.1). 'Back pain' with no region is M54.9, dorsalgia unspecified; thoracic back pain is M54.6; neck pain is M54.2. None of the M54 codes carry laterality except sciatica and lumbago with sciatica.
Common questions
- What is the ICD-10 code for low back pain?
- M54.50, low back pain, unspecified. M54.51 is vertebrogenic low back pain and M54.59 is other low back pain. M54.5 without a fifth character has been invalid since FY2022.
- What is the ICD-10 code for low back pain with sciatica?
- M54.4- lumbago with sciatica: M54.41 right side, M54.42 left side, M54.40 unspecified side. Do not add M54.50 as well.
- What is the ICD-10 code for chronic low back pain?
- G89.29, other chronic pain, together with M54.50 (or the more specific site code). Sequence G89.29 first when the visit is for pain management.