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Effective 9/30/21--M54.5 Is No Longer Billable

23 Oct 2021 4:52 PM | Amy Thomason (Administrator)

by Robbin Blake

September 30, 2021 was the last day M54.5, lumbago (low back pain), was a valid and billable ICD-10 diagnosis code. Beginning October 1, 2021, all healthcare providers should have changed this code to one of the newly created back pain codes which are:

• S39.012, Low back strain
• M51.2-, Lumbago due to intervertebral disc displacement
• M54.4-, Lumbago with sciatica
• M54.50, Low back pain, unspecified
• M54.51: Vertebrogenic low back pain
• M54.59: Other low back pain

There is also a warning that S39.012 “Strain of muscle, fascia and tendon of lower back” should not be used with any other diagnosis beginning with M51.2-, M54.4-, or M54.5- as it will likely result in claim denial. 

You can find more detail about M54.5 and S39.012 at:



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