ICD-10 Coding for Sciatica, Left(M54.32, M54.42)
Complete ICD-10-CM coding and documentation guide for Sciatica, Left. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Sciatica, Left
M54.3-M54.4Primary Range
Dorsalgia, including sciatica and lumbago with sciatica
This range includes codes for sciatica and lumbago with sciatica, specifically addressing left-sided symptoms.
Intervertebral disc disorders with radiculopathy
This range is relevant when sciatica is due to intervertebral disc disorders.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M54.32 | Sciatica, left side | Use when sciatica is isolated to the left side without accompanying lumbago. |
|
| M54.42 | Lumbago with sciatica, left side | Use when both low back pain and left-sided sciatica are documented. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for left-sided sciatica
Essential facts and insights about Sciatica, Left
Primary ICD-10-CM Codes for sciatica left
Decision Criteria
clinical Criteria
- Presence of left-sided radiating leg pain without low back pain
documentation Criteria
- Documented positive left SLR test
Applicable To
- Left-sided sciatica without lumbago
Excludes
- Sciatica due to intervertebral disc disorders (M51.1-)
Clinical Validation Requirements
- Radiating pain down the left leg
- Positive straight leg raise test on the left
- Imaging showing nerve compression
Code-Specific Risks
- Incorrectly using this code when lumbago is present
- Failing to document laterality
Coding Notes
- Ensure documentation specifies the side and absence of lumbago.
M54.42 - Lumbago with sciatica, left side
Use when both low back pain and left-sided sciatica are documented.
Applicable To
- Left-sided sciatica with low back pain
Excludes
- Sciatica due to intervertebral disc disorders (M51.1-)
Clinical Validation Requirements
- Low back pain with radiation to the left leg
- Reduced lumbar range of motion
- Positive left SLR test
Coding Notes
Ensure documentation specifies both low back pain and left-sided sciatica.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Sciatica, Left to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M54.32.
Impact
Clinical: May lead to incorrect treatment planning, Regulatory: Non-compliance with coding specificity requirements, Financial: Potential for reduced reimbursement
Mitigation Strategy
Always document the affected side in clinical notes, Use templates that prompt for laterality
Impact
Reimbursement: May lead to lower reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines for specificity., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies the affected side to use the correct code.
Impact
Using unspecified codes when laterality is documented
Mitigation Strategy
Implement regular audits to ensure side-specific codes are used
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 Sciatica, Left, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Sciatica, Left
Use these documentation templates to ensure complete and accurate documentation for Sciatica, Left. These templates include all required elements for proper coding and billing.
Patient with left-sided sciatica
Specialty: ChiropracticRequired Elements
- Subjective: Patient's description of symptoms
- Objective: Physical exam findings
- Assessment: Diagnosis code
- Plan: Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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