M54.5
Header — not billableLow back pain
The ICD-10 code for low back pain is M54.5.
M54.5 is a non-billable header code. It groups related conditions but cannot be used on its own for reimbursement — select one of the 3 more specific codes below.
Clinical notes
Excludes1 (not coded here)
An Excludes1 note is a pure exclusion: the excluded condition and this code should never be reported together, because the two conditions cannot occur at the same time (e.g. a congenital form vs. an acquired form of the same disease).
Documentation support
General coding-documentation guidance — not a substitute for payer-specific requirements or professional coding judgment.
- •This is a non-billable header code. Documentation must support a more specific child code before this diagnosis can be reported on a claim.
- •Confirm the excluded condition(s) listed above are not also present — Excludes1 conditions cannot be coded together with this one.
- •As a general rule, code to the highest level of specificity supported by the documentation in the medical record.
Child codes under M54.5
Related codes in this category
- M54.0Panniculitis affecting regions of neck and backnon-billable header
- M54.1Radiculopathynon-billable header
- M54.2Cervicalgia
- M54.3Sciaticanon-billable header
- M54.4Lumbago with sciaticanon-billable header
- M54.6Pain in thoracic spine
- M54.8Other dorsalgianon-billable header
- M54.9Dorsalgia, unspecified
- M54.5Low back painnon-billable header
ICD-9-CM equivalent
Informational only — GEM mappings are approximate, not guaranteed one-to-one equivalents. Verify before use in billing.
- 7242