Back Pain ICD-10 Codes: Complete Guide to M54 and Related Codes

  • Jan 31, 2025

Back pain is one of the most common reasons patients seek medical care, making accurate coding essential for proper reimbursement. This guide covers ICD-10-CM codes for dorsalgia (M54), radiculopathy (M54.1), and related spinal conditions.

Quick Reference: Back Pain Code Categories

CategoryCode RangeDescription
M54M54.0-M54.9Dorsalgia (back pain)
M47M47.0-M47.9Spondylosis
M51M51.0-M51.9Disc disorders
M53M53.0-M53.9Other dorsopathies

M54: Dorsalgia (Back Pain)

The M54 category is the primary code family for back pain without underlying structural pathology.

M54 Code Options

CodeDescriptionCommon Use
M54.2Cervicalgia (neck pain)Neck pain without radiculopathy
M54.4Lumbago with sciaticaLow back pain radiating to leg
M54.40Lumbago with sciatica, unspecified sideUnspecified laterality
M54.41Lumbago with sciatica, right sideRight-sided symptoms
M54.42Lumbago with sciatica, left sideLeft-sided symptoms
M54.5Low back painMost common back pain code
M54.50Low back pain, unspecifiedWithout further specification
M54.51Vertebrogenic low back painVertebra-originating pain
M54.59Other low back painOther specified low back pain
M54.6Pain in thoracic spineMid-back pain
M54.89Other dorsalgiaOther back pain NEC
M54.9Dorsalgia, unspecifiedBack pain NOS

M54.5: Low Back Pain (Most Common)

M54.5 is the most frequently used back pain code. Use this when documentation indicates:

  • Low back pain
  • Lumbago
  • Lower back pain
  • LBP

Excludes1 (Cannot code together):

  • Low back strain (S39.012)
  • Lumbago due to intervertebral disc displacement (M51.1-)
  • Lumbago with sciatica (M54.4-)

Important: If documentation specifies radiating pain to the leg (sciatica), use M54.4x codes instead.

View M54.5 code details →

M54.1: Radiculopathy

M54.1 codes are used for nerve root compression causing radiating pain.

Radiculopathy Code Options

CodeDescription
M54.10Radiculopathy, site unspecified
M54.11Radiculopathy, occipito-atlanto-axial region
M54.12Radiculopathy, cervical region
M54.13Radiculopathy, cervicothoracic region
M54.14Radiculopathy, thoracic region
M54.15Radiculopathy, thoracolumbar region
M54.16Radiculopathy, lumbar region
M54.17Radiculopathy, lumbosacral region
M54.18Radiculopathy, sacral and sacrococcygeal region

When to Use Radiculopathy vs Sciatica

Use M54.1x (Radiculopathy):

  • Documentation states "radiculopathy"
  • Nerve root involvement documented
  • Multiple dermatomal involvement

Use M54.4x (Lumbago with Sciatica):

  • Documentation states "sciatica"
  • Pain radiating from low back down leg
  • Sciatic nerve distribution symptoms

View all M54.1 codes →

Disc Disorders (M51)

When back pain is due to intervertebral disc pathology, use M51 codes instead of M54.

Common Disc Codes

CodeDescription
M51.06Disc degeneration, lumbar region
M51.16Disc herniation, lumbar region
M51.17Disc herniation, lumbosacral region
M51.26Disc degeneration with radiculopathy, lumbar
M51.27Disc degeneration with radiculopathy, lumbosacral

Key Distinction:

  • M51.0x = Disc degeneration (degenerative disc disease)
  • M51.1x = Disc herniation with radiculopathy
  • M51.2x = Other disc degeneration

Spondylosis (M47)

M47 codes are used when back pain is due to degenerative spinal changes.

Common Spondylosis Codes

CodeDescription
M47.816Spondylosis without myelopathy, lumbar
M47.817Spondylosis without myelopathy, lumbosacral
M47.896Other spondylosis, lumbar
M47.26Spondylosis with radiculopathy, lumbar

Common Coding Scenarios

Scenario 1: Simple Low Back Pain

Documentation: Patient presents with low back pain of 2 weeks duration. No radiation to legs. Code: M54.50 - Low back pain, unspecified

Scenario 2: Low Back Pain with Sciatica

Documentation: Low back pain radiating down the right leg in sciatic distribution. Code: M54.41 - Lumbago with sciatica, right side

Scenario 3: Cervical Radiculopathy

Documentation: Neck pain with numbness and tingling in C6 distribution to the right arm. Code: M54.12 - Radiculopathy, cervical region

Scenario 4: Lumbar Disc Herniation with Radiculopathy

Documentation: L4-5 disc herniation with radiculopathy. Codes:

  1. M51.16 - Intervertebral disc disorders with radiculopathy, lumbar region

Scenario 5: Chronic Low Back Pain

Documentation: Chronic low back pain, patient seen for pain management. Code: M54.50 - Low back pain, unspecified (note: ICD-10-CM does not distinguish acute vs chronic)

Scenario 6: Post-Laminectomy Syndrome

Documentation: Failed back surgery syndrome, chronic pain after lumbar laminectomy. Code: M96.1 - Postlaminectomy syndrome, not elsewhere classified

Laterality and Site Specificity

Many back pain codes require site specification:

  • Cervical region = Neck (C1-C7)
  • Cervicothoracic region = Lower neck/upper back junction
  • Thoracic region = Mid-back (T1-T12)
  • Thoracolumbar region = Lower mid-back junction
  • Lumbar region = Low back (L1-L5)
  • Lumbosacral region = Low back/sacral junction
  • Sacral/sacrococcygeal region = Tailbone area

Frequently Asked Questions

What is the ICD-10 code for low back pain?

M54.5 is the code category for low back pain. The most specific billable codes are M54.50 (unspecified), M54.51 (vertebrogenic), or M54.59 (other low back pain).

What is the difference between M54.5 and M54.4?

M54.5 is used for low back pain without leg radiation. M54.4 is used when low back pain radiates down the leg (lumbago with sciatica).

When should I use M54.5 vs G89.29?

Use M54.5 for low back pain as the primary diagnosis. G89.29 (Other chronic pain) may be added as a secondary code if chronic pain management is documented.

Is M54.50 billable?

Yes, M54.50 (Low back pain, unspecified) is a valid billable code for low back pain when further specification is not documented.

Can I code M54.5 with M51?

Yes, but only if the conditions are documented as separate issues. If the low back pain is caused by the disc disorder, code only the disc disorder (M51), as it captures the underlying cause.

What code is used for neck pain?

M54.2 (Cervicalgia) is the code for neck pain. For neck pain with arm symptoms, consider M54.12 (cervical radiculopathy) if nerve root involvement is documented.

How do I code back pain after an injury?

Acute traumatic back pain uses S-codes (e.g., S39.012 for low back strain). M54 codes are for non-traumatic back pain or when the traumatic injury has healed but pain persists.

Last updated: January 2025. Code data reflects ICD-10-CM 2026 version.