M54.5: Oh, My Aching BACK!

Updated: Feb 4

ICD-10 Codes: Annual Updates and Changes - Effective October 1, 2021

INSIGHTS! from SMBS



Don't Let M54.5 be the

Straw That Breaks YOUR Back!


Sound Medical Billing Solutions can help alleviate your back problems...and so much more!




The Annual CMS Updates of ICD-10 can take many by surprise. Commonly used diagnosis codes can be updated to require greater levels of detail, or can be removed from acceptance. Continued use of the changed or deleted code will render claims unpayable for any date of service on or after the effective date of October 1st.


This year, CMS has deleted one of the most commonly used codes in rehabilitation practices - M54.5. Starting October 1, 2021, therapists must code to a higher level of specificity for all patients regardless of the payer, Medicare, Commercial, Worker's Compensation and No-Fault.


At SMBS...We've Got Your BACK!

M54.5 Low Back Pain

M54.5 Low Back Pain has been DELETED, as of October 1, 2021, and replaced with the following:

  • M54.50 Low back pain, unspecified

  • M54.51 Vertebrogenic low back pain

  • M54.59 Other low back pain

Additional codes to consider are referenced to include the following designations:
S39.012 Low Back Strain
M51.2(?) Lumbago due to Intervertebral Disc Displacement
M54.4(?) Lumbago with Sciatica
*see the full code set for these and other options to best code your patient's presentation


Additional ICD-10 Changes that may affect your Physical Therapy or Chiropractic practice:

DELETED

M45.A Non-radiographic axial spondyloarthritis

NEW

M45.A0 Non-radiographic axial spondyloarthritis of unspecified sites in spine
M45.A1 Non-radiographic axial spondyloarthritis of occipito-atlanto-axial region
M45.A2 Non-radiographic axial spondyloarthritis of cervical region
M45.A3 Non-radiographic axial spondyloarthritis of cervicothoracic region
M45.A4 Non-radiographic axial spondyloarthritis of thoracic region
M45.A5 Non-radiographic axial spondyloarthritis of thoracolumbar region
M45.A6 Non-radiographic axial spondyloarthritis of lumbar region
M45.A7 Non-radiographic axial spondyloarthritis of lumbosacral region
M45.A8 Non-radiographic axial spondyloarthritis of sacral and sacrococcygeal region
M45.AB Non-radiographic axial spondyloarthritis of multiple sites in spine


BEST PRACTICE:

Review the ICD10 Code Change List and Active Tabular List to identify ICD10 code changes and Active ICD10 codes that may benefit your professional practice.
  1. UPDATES and CHANGES can be found at: om/ICD10CM/Codes/Changes/New_Codes/1?year=2022

  2. The complete active ICD10 Tabular List can be found at: https://www.icd10data.com/ICD10CM/Codes

Give us a call and we will be happy to highlight the ICD-10 code changes for your specialty!

 

Let us provide your SOUND MEDICAL BILLING SOLUTIONS!



John Spiezio, President

Sound Medical Billing Solutions, LLC

 

Call, click or email for more information about this or any other topic that my affect your practice. We will be happy to help!

Contact Us at:

tel: 631-343-3147
email: soundmedicalbilling@verizon.net
website: www.soundmedicalbilling.com

The Outpatient Rehabilitation Practice Management and Billing Specialists!
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