M54.5

Low back pain

Diseases of the musculoskeletal system and connective tissue Billable
Quick Reference
Pain localized to lumbar or lumbosacral region without radiculopathy

Clinical Information

When to Use This Code

Pain localized to lumbar or lumbosacral region without radiculopathy

Common Clinical Scenarios

  • Acute low back strain or sprain
  • Chronic mechanical low back pain
  • Non-specific lower back pain
  • Back pain after lifting or physical activity

Documentation Requirements

  • Specify location (lumbar, lumbosacral)
  • Document acute vs. chronic (>12 weeks)
  • Note radiation to legs if present (use M54.16 for radiculopathy)
  • Record aggravating/alleviating factors and functional impact

Coding Guidelines

Inclusion Terms

These terms are included in this code:

LumbagoLow back painLumbar painLower back pain

Exclusion Terms

Do NOT use this code for:

  • Sciatica with lumbago (M54.4-)
  • Low back pain with radiculopathy (M54.16)
  • Pain due to intervertebral disc disorder (M51.-)

Coding Notes

Most common musculoskeletal diagnosis code
Use M54.16 if radiculopathy present
Code underlying disc disease separately if identified

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Code Details

Code
M54.5
Category
Diseases of the musculoskeletal system and connective tissue
Billable Status
Billable

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