ICD-10 M54.5 Deleted Effective October 1, 2021!

Today is October 8, 2021. Have you not noticed your claims are being rejected by your practice management clearinghouse as "Invalid ICD-10 Code"?

ICD-10 M54.5 DELETED EFFECTIVE OCTOBER 1, 2021

​ICD-10 Pain Management Code M54.5 Deleted Effective October 1, 2021!

Yes?! Well, it is because the ICD-10 code M54.5 for Low Back Pain is now deleted effective all date of service from October 1, 2021!
So make sure you are aware of this and correct your claims by choosing the billable and appropriate ICD-10 code that will describe your deleted code M54.5.

Belo are some potential code replacements that you can use beginning October 1, 2021

• S39.012, Low back strain
• M51.2-, Lumbago due to intervertebral disc displacement
• M54.4-, Lumbago with sciatica
• M54.50, Low back pain, unspecified
• M54.51: Vertebrogenic low back pain
• M54.59: Other low back pain

Insurance Prior Authorization Services, Patients Access and Medical Documentation Reviews and Audits.

New Codes you can potentially use:
S39.012, Low back strain
M51.2-, Lumbago due to intervertebral disc displacement
M54.4-, Lumbago with sciatica
M54.50, Low back pain, unspecified
M54.51: Vertebrogenic low back pain
M54.59: Other low back pain

Low Back Pain ICD-10 M54.5 DELETED EFFECTIVE OCTOBER 1, 2021

Remember that when changes like this happens, this is not just for CMS Medicare claims but it applies to all commercial payers (at least the big insurance payers!).

Read more about this updates and change by clicking here https://www.cms.gov/medicare/icd-10/2022-icd-10-cm 

Medical Practice Consultants for Pain Management & ASC Ambulatory Surgery Center