ICD-10-CM Diagnosis Code M54.40 - Lumbago with sciatica, unspecified side (original) (raw)

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ICD List 2025-2026 Edition

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Lumbago with sciatica, unspecified side

ICD-10-CM Code:

M54.40

ICD-10 Code for:

Lumbago with sciatica, unspecified side

Is Billable?

Yes - Valid for Submission

Chronic Condition Indicator: [1]

Chronic

Code Navigator:

M54.40 is a billable diagnosis code used to specify a medical diagnosis of lumbago with sciatica, unspecified side. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2025 through September 30, 2026.

This medical diagnosis code is frequently used in Orthopedics medical specialties to designate conditions such neck and back pain.

Unspecified diagnosis codes like M54.40 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.

  1. Code Information
  2. Approximate Synonyms
  3. Clinical Classification
  4. Tabular List of Diseases and Injuries
  5. Diagnostic Related Groups Mapping
  6. Convert to ICD-9 Code
  7. Patient Education
  8. Other Codes Used Similar Conditions
  9. Code History

The following list of clinical terms are approximate synonyms, alternative descriptions, or common phrases that might be used by patients, healthcare providers, or medical coders to describe the same condition. These synonyms and related diagnosis terms are often used when searching for an ICD-10 code, especially when the exact medical terminology is unclear. Whether you're looking for lay terms, similar diagnosis names, or common language alternatives, this list can help guide you to the correct ICD-10 classification.

Clinical Classifications group individual ICD-10-CM diagnosis codes into broader, clinically meaningful categories. These categories help simplify complex data by organizing related conditions under common clinical themes.

They are especially useful for data analysis, reporting, and clinical decision-making. Even when diagnosis codes differ, similar conditions can be grouped together based on their clinical relevance. Each category is assigned a unique CCSR code that represents a specific clinical concept, often tied to a body system or medical specialty.

CCSR Code: MUS038

Inpatient Default: N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.

Outpatient Default: N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.

CCSR Code: MUS011

Inpatient Default: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.

Outpatient Default: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Below are the ICD-9 codes that most closely match this ICD-10 code, based on the General Equivalence Mappings (GEMs). This ICD-10 to ICD-9 crosswalk tool is helpful for coders who need to reference legacy diagnosis codes for audits, historical claims, or approximate code comparisons.

ICD-9-CM: 724.3

Approximate Flag - The approximate mapping means this ICD-10 code does not have an exact ICD-9 equivalent. The matched code is the closest available option, but it may not fully capture the original diagnosis or clinical intent.

Back Pain

If you've ever groaned, "Oh, my aching back!", you are not alone. Back pain is one of the most common medical problems, affecting 8 out of 10 people at some point during their lives. Back pain can range from a dull, constant ache to a sudden, sharp pain. Acute back pain comes on suddenly and usually lasts from a few days to a few weeks. Back pain is called chronic if it lasts for more than three months.

Most back pain goes away on its own, though it may take awhile. Taking over-the-counter pain relievers and resting can help. However, staying in bed for more than 1 or 2 days can make it worse.

If your back pain is severe or doesn't improve after three days, you should call your health care provider. You should also get medical attention if you have back pain following an injury.

Treatment for back pain depends on what kind of pain you have, and what is causing it. It may include hot or cold packs, exercise, medicines, injections, complementary treatments, and sometimes surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

[Learn More in MedlinePlus]

Sciatica

Sciatica is a symptom of a problem with the sciatic nerve, the largest nerve in the body. It controls muscles in the back of your knee and lower leg and provides feeling to the back of your thigh, part of your lower leg, and the sole of your foot. When you have sciatica, you have pain, weakness, numbness, or tingling. It can start in the lower back and extend down your leg to your calf, foot, or even your toes. It's usually on only one side of your body.

Causes of sciatica include:

In many cases no cause can be found.

Sometimes sciatica goes away on its own. Treatment, if needed, depends on the cause of the problem. It may include exercises, medicines, and surgery.

[Learn More in MedlinePlus]

Back Pain

Back pain is one of the most common medical problems in the United States. It might feel like a dull, constant ache or a sudden, sharp pain.
[Learn More in MedlinePlus]