ICD-10 Coding for Chronic Bilateral Low Back Pain Without Sciatica(M54.50)
Complete ICD-10-CM coding and documentation guide for Chronic Bilateral Low Back Pain Without Sciatica. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Chronic Bilateral Low Back Pain Without Sciatica
M54.5-M54.50Primary Range
Low back pain codes
This range includes codes for low back pain, with M54.50 specifically for chronic bilateral low back pain without sciatica.
Chronic pain codes
G89.29 is used for chronic pain, often in conjunction with M54.50 when chronicity is documented.
Key Information: ICD-10 code for chronic bilateral low back pain without sciatica
Essential facts and insights about Chronic Bilateral Low Back Pain Without Sciatica
Primary ICD-10-CM Code for chronic bilateral low back pain without sciatica
Decision Criteria
clinical Criteria
- Pain lasting ≥3 months without sciatica.
documentation Criteria
- Explicit mention of 'chronic bilateral low back pain without sciatica'.
Applicable To
- Chronic bilateral low back pain without sciatica
Clinical Validation Requirements
- Pain duration ≥3 months
- No radicular symptoms
- Bilateral involvement
Code-Specific Risks
- Misclassification if sciatica is present
- Incorrect use without chronicity documentation
Coding Notes
- Ensure documentation specifies chronicity and bilateral nature.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other chronic pain
G89.29Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Chronic Bilateral Low Back Pain Without Sciatica to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M54.50.
Impact
Clinical: Inaccurate treatment planning, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Educate providers on documentation standards, Use templates for consistent documentation
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Verify documentation for bilateral involvement and use M54.50.
Impact
Audits may target records lacking clear chronicity documentation.
Mitigation Strategy
Ensure all records specify pain duration and bilateral nature.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Chronic Bilateral Low Back Pain Without Sciatica, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Chronic Bilateral Low Back Pain Without Sciatica
Use these documentation templates to ensure complete and accurate documentation for Chronic Bilateral Low Back Pain Without Sciatica. These templates include all required elements for proper coding and billing.
Primary Care Visit for Chronic Low Back Pain
Specialty: Primary CareRequired Elements
- Pain duration
- Bilateral involvement
- Absence of sciatica
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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