M54.5ICD-10-CM

Low back pain (deleted, FY 2022)

Not billable

Chapter

M00-M99

Musculoskeletal

Billable

A category header or retired code — it rejects at the clearinghouse

What the documentation has to carry

Deleted effective October 1, 2021 and replaced by M54.50, M54.51, and M54.59. Still one of the most common invalid codes on inbound claims.

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before the payer does

TruRev validates diagnosis specificity, sequencing, and medical necessity at charge entry, then routes what fails to a certified coder instead of the clearinghouse.

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This page is a free reference for billing and coding teams and is not coding, legal, or clinical advice. Code selection depends on the documentation in the record and on the policy of the payer being billed. Verify every code, instructional note, and sequencing rule against the current ICD-10-CM files and the Official Guidelines for Coding and Reporting for the applicable date of service. ICD-10-CM is maintained by the CDC's National Center for Health Statistics and published by CMS. CPT is a registered trademark of the American Medical Association. TruCare is not affiliated with CMS, NCHS, the AHA, or the AMA.

Low back pain (deleted, FY 2022)

What the documentation has to carry

Find the specificitybefore the payer does

Find the specificity
before the payer does