ICD-10-CM Diagnosis Code M54.5 - Low back pain (original) (raw)

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ICD List 2025-2026 Edition

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Low back pain

ICD-10-CM Code:

M54.5

ICD-10 Code for:

Low back pain

Is Billable?

Not Valid for Submission

Chronic Condition Indicator: [1]

Not chronic

Code Navigator:

M54.5 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity from the list below for a diagnosis of low back pain. The code is not specific and is NOT valid for the year 2026 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

This medical diagnosis code is frequently used in Family Practice, Internal Medicine, and Orthopedics medical specialties to designate conditions such back and neck pain.

Non-specific codes like M54.5 require more digits to indicate the appropriate level of specificity. Consider using any of the following billable codes with a higher level of specificity when coding for low back pain:

Use M54.50 for Low back pain, unspecified

Use M54.51 for Vertebrogenic low back pain

Use M54.59 for Other low back pain

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

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: 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.

acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions.

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: 724.2

This is a direct match with no additional mapping qualifiers. The absence of a flag generally means the mapping is considered exact or precise. In other words, the ICD-10 code maps cleanly to the ICD-9 code without qualification, approximation, or needing multiple codes.

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]

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]