ICD Code M54.04

ICD code M5404 is used to identify a medical condition known as panniculitis affecting the thoracic region of the neck and back. Panniculitis refers to the inflammation of the subcutaneous fat layer beneath the skin, which can lead to symptoms such as pain, swelling, and the formation of nodules or lumps. When this condition specifically affects the thoracic region, it involves the upper and middle parts of the back, potentially impacting the patient's mobility and comfort. This code is crucial for healthcare providers to accurately document and manage the treatment of this specific condition within the revenue cycle management process.

When considering the use of the ICD code for panniculitis affecting regions of the neck and back, specifically the thoracic region, healthcare providers should evaluate the following diagnostic criteria and symptoms:

1. Localized Pain and Tenderness: Presence of pain and tenderness specifically in the thoracic region of the back, which may be exacerbated by pressure or movement.

2. Subcutaneous Nodules: Detection of palpable nodules or lumps beneath the skin in the thoracic area, which may vary in size and consistency.

3. Inflammatory Signs: Observation of redness, warmth, or swelling in the affected area, indicating an inflammatory process.

4. Skin Changes: Notable changes in the skin overlying the affected area, such as thickening, discoloration, or dimpling.

5. Systemic Symptoms: Accompanying systemic symptoms such as fever, malaise, or fatigue, which may suggest a more widespread inflammatory response.

6. Exclusion of Other Conditions: Ruling out other potential causes of similar symptoms, such as infections, malignancies, or autoimmune disorders, through appropriate diagnostic testing.

7. Chronicity and Recurrence: Documentation of chronic or recurrent episodes of the symptoms, which may help differentiate from acute conditions.

8. Response to Treatment: Evaluation of the response to anti-inflammatory or other therapeutic interventions, which may support the diagnosis if symptoms improve.

By carefully assessing these criteria, healthcare providers can determine the appropriateness of using the ICD code for this specific condition.

For the ICD code M54.04, which pertains to panniculitis affecting regions of the neck and back, thoracic region, the relevant CPT codes that may be applicable for treatment include:

1. 20550 - Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar "fascia").

2. 20610 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); without ultrasound guidance.

3. 64450 - Injection, anesthetic agent; other peripheral nerve or branch.

4. 97035 - Application of a modality to 1 or more areas; ultrasound, each 15 minutes.

5. 97110 - Therapeutic exercises to develop strength and endurance, range of motion, and flexibility (each 15 minutes).

These CPT codes are examples of procedures that might be used in the management or treatment of conditions associated with the ICD code M54.04. It is important for healthcare providers to select the most appropriate CPT code based on the specific treatment plan and interventions provided to the patient. Always ensure that the selected CPT codes align with the services rendered and are supported by the patient's medical documentation.

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