ICD-10-CM diagnosis code M54.5 is a billable specific code used to classify chronic low back pain, one of the most common musculoskeletal complaints affecting adults worldwide.
This 2025 ICD-10-CM diagnosis code is important for reimbursement purposes, clinical documentation, and accurate pain management tracking.
Effective October 1, 2024, under the 2025 edition of ICD-10-CM, this code remains part of the International Classification of Diseases (ICD-10-CM) used in the American ICD-10-CM version for standardizing pain diagnosis and billing across the U.S.
M54.5 designates chronic low back pain without a specific underlying condition listed. It applies to cases where pain persists for 12 weeks or longer, but the exact source of discomfort. Such as intervertebral disc disorder or nerve root irritation, is not specified.
In the international versions of ICD-10, this code is equally recognized as a billable specific ICD-10-CM diagnosis code, ensuring continuity across healthcare systems for pain-related reporting and reimbursement.
Note: M54.5 should not be used for acute back pain. Use only when pain is persistent and unrelated to immediate trauma.
Chronic low back pain can stem from multiple causes, including:
Clinically, patients may describe symptoms as dull, radiating, or sharp pain, sometimes extending to the legs.
In older adults or individuals with occupational strain, intervertebral disc degeneration in the lumbar region with discogenic back pain only is a common contributor.
|
ICD-10 Code |
Description |
|
M54.5 |
Chronic low back pain (billable specific code) |
|
M54.41 |
Lumbago with sciatica, right side – may indicate nerve compression |
|
M54.42 |
Lumbago with sciatica, left side – often linked to intervertebral disc degeneration in the lumbosacral region |
|
M51.2 |
Intervertebral disc displacement, lumbar region, with discogenic back pain only |
|
M54.6 |
Pain in the thoracic spine |
|
M54.88 |
Other dorsalgia |
|
M54.9 |
Dorsalgia, unspecified |
|
S39.012 |
Strain of the muscle, fascia, or tendon of the lower back |
Select the correct code, whether for lumbago due to intervertebral disc displacement or degenerative disc disease, is important to ensure compliant documentation and accurate claim submission.
When coding chronic back pain, ensure your documentation supports:
Correct coding helps healthcare providers:
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M54.5 isn’t just a diagnosis; it’s central to understanding and treating a major cause of disability worldwide.
For reimbursement purposes, this code ensures that chronic pain management services, including evaluations, imaging, and therapies, are properly billed and justified.
Cures billing experts consistently find that refining spine-related coding (like M54.5, M54.42, and M51.2) reduces claim rejections and maximizes collections for clinics.
Such as when pain is localized to the lumbosacral region with discogenic back pain only, prefer M51.2 over M54.5.
ICD-10 Code M54.5 remains a critical billable specific ICD-10-CM diagnosis code for chronic low back pain in the 2025 edition of ICD-10-CM.
Proper coding ensures that healthcare providers receive accurate reimbursement and that patient care strategies align with documented pain severity and duration.
Whether you’re treating chronic low back pain from intervertebral disc degeneration in the lumbosacral region or muscular strain, the right coding makes a measurable difference in compliance, claim success, and care delivery.
Need Help with Back Pain Claims? Cures specializes in ICD-10-CM pain management billing and compliance.
Our experts can help you audit spine-related claims, correct coding errors, and recover lost revenue.
Contact our billing experts today to optimize your chronic low back pain coding and ensure full reimbursement for your services.
M54.5 is used to document chronic low back pain, especially when the cause is not linked to an acute injury or specific spinal condition. It assistances make sure correct diagnosis and proper reimbursement.
While M54.5 refers to general low back pain, M54.41 and M54.42 are used when the pain involves lumbago with sciatica on the right or left side, often due to intervertebral disc degeneration or displacement.
Not directly. If recording degeneration is confirmed, it’s better to use a more specific code like M51.2 for discogenic back pain or disc displacement in the lumbar region, paired with symptom codes if needed.
Yes. Using M54.5 without clinical specificity may lead to lower reimbursement. It’s important to support the code with thorough documentation, including history, duration, and imaging findings.
The 2025 edition of ICD-10-CM became effective on October 1, 2024, aligning with the annual updates to the International Classification of Diseases system.
Common related codes include M54.41 (lumbago with sciatica, right side), M54.42 (lumbago with sciatica, left side), and M51.2 (intervertebral disc displacement in the lumbar region).
It refers to degenerative changes in the intervertebral disc of the lower spine, often associated with discogenic back pain or lumbago due to intervertebral disc displacement.
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