What is the ICD-10 code for low back pain?

The ICD-10-CM code for low back pain is M54.50 when documented without further specification. More specific documentation changes the code — see the scenario table.

Yes — M54.50 is a billable ICD-10-CM code, but payers expect the most specific code the documentation supports.

ICD-10 Code for low back pain

The ICD-10-CM code for low back pain is M54.50 when documented without further specification. Low back pain was expanded in FY2022: M54.5 requires a 6th character. M54.50 is the unspecified default; sciatica involvement changes the code.

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Which Code Should You Use?

M54.50 ✓ Billable — Low back pain, unspecified

Low back pain, unspecified - no further detail documented.

M54.51 ✓ Billable — Vertebrogenic low back pain

Vertebrogenic low back pain (documented vertebral endplate origin).

M54.59 ✓ Billable — Other low back pain

Other specified low back pain.

M54.40 ✓ Billable — Lumbago with sciatica, unspecified side

Lumbago WITH sciatica, unspecified side.

S39.012 ✓ Billable — Strain of muscle, fascia and tendon of lower back

Low back strain from a documented injury - injury coding applies (7th character required, e.g. A for initial encounter), with external-cause codes.

What to Document

Laterality when sciatica is involved (M54.41 right, M54.42 left).
Traumatic vs non-traumatic origin (injury codes vs M54.-).
Underlying cause if known (disc displacement M51.-, spondylosis M47.-) - code the cause instead when established.

Also Known As

Official ICD-10-CM Alphabetic Index terms that point to M54.50:

Lumbago, lumbalgia
Pain (s) › loin
Pain (s) › low back
Pain (s) › lumbar region
Low › back syndrome
Syndrome › low › back
Pain (s) › spine › low back

Coding Notes

M54.5 without a 6th character is not billable. If imaging-confirmed disc disease or another definitive cause is documented, code that condition rather than the symptom code.

Prevalence & Statistics

In 2018, 28.0% of U.S. men and 31.6% of U.S. women aged 18 and older had lower back pain in the past 3 months. (CDC MMWR QuickStats (National Health Interview Survey, 2018), 2018)