The new ICD-10 codes, effective October 1, 2024, must be implemented immediately to ensure proper reimbursement, including for UDS claims.
Now M51.36 and M51.37 are considered as non-specific codes. The following new codes have been developed:
M51.360 Other intervertebral disc degeneration, lumbar region with discogenic back pain only
Other intervertebral disc degeneration, lumbar region with axial back pain only
M51.361 Other intervertebral disc degeneration, lumbar region with lower extremity pain only
Other intervertebral disc degeneration, lumbar region with leg pain only
Other intervertebral disc degeneration, lumbar region with referred sclerotomal pain only
M51.362 Other intervertebral disc degeneration, lumbar region with discogenic back pain and lower extremity pain
Other intervertebral disc degeneration, lumbar region with discogenic back pain and leg pain
Other intervertebral disc degeneration, lumbar region with axial back pain and referred sclerotomal pain
M51.369 Other intervertebral disc degeneration, lumbar region without mention of lumbar back pain or lower extremity pain
Other intervertebral disc degeneration, lumbar region without mention of lumbar back pain or leg pain
Other intervertebral disc degeneration, lumbar region, NOS
M51.370 Other intervertebral disc degeneration, lumbosacral region with discogenic back pain only
Other intervertebral disc degeneration, lumbosacral region with axial back pain only
M51.371 Other intervertebral disc degeneration, lumbosacral region with lower extremity pain only
Other intervertebral disc degeneration, lumbosacral region with leg pain only
Other intervertebral disc degeneration, lumbosacral region with referred sclerotomal pain only
M51.372 Other intervertebral disc degeneration, lumbosacral region with discogenic back pain and lower extremity pain
Other intervertebral disc degeneration, lumbosacral region with discogenic backpain and leg pain
Other intervertebral disc degeneration, lumbosacral region with axial back pain and referred sclerotomal pain
M51.379 Other intervertebral disc degeneration, lumbosacral region without mention of lumbar back pain or lower extremity pain
Other intervertebral disc degeneration, lumbosacral region without mention of lumbar back pain or leg pain
Other intervertebral disc degeneration, lumbosacral region, NOS
M54.5 Low back pain
Excludes1: intervertebral disc degeneration, lumbar region with discogenic back pain only(M51.360)
intervertebral disc degeneration, lumbosacral region with discogenic back pain only(M51.370)
M54.3 Sciatica
Excludes1: intervertebral disc degeneration, lumbar region with lower extremity pain only(M51.361)
intervertebral disc degeneration, lumbosacral region with lower extremity pain only(M51.371)
M54.4 Lumbago with sciatica
Excludes1: intervertebral disc degeneration, lumbar region with discogenic back pain and lower extremity pain (M51.362)
intervertebral disc degeneration, lumbosacral region with discogenic back pain and lower extremity pain (M51.372)
However, these codes have not been updated with Medicaid, etc. Consequently, for facet joint pain the codes remain M47.816 and M47.817.
Similarly for radicular pain, lumbar radiculitis, M51.16 and M51.17 will remain.
See the following link to CMS: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56818&ver=45&=
