ICD Code M54.05

ICD code M54.05 is used to identify a specific medical condition known as panniculitis affecting the thoracolumbar 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 tenderness in the affected area. The thoracolumbar region is the part of the spine that includes the lower thoracic vertebrae and the upper lumbar vertebrae, essentially the middle to lower back area. This code is utilized by healthcare providers to accurately document and communicate this particular diagnosis for purposes such as treatment planning, billing, and insurance claims.

When considering the use of the ICD code M5405, the following diagnostic criteria and symptoms should be evaluated:

1. Location of Symptoms:
- Presence of panniculitis specifically in the neck and back regions, particularly the thoracolumbar area.

2. Physical Examination Findings:
- Palpable subcutaneous nodules or masses in the affected regions.
- Erythema or swelling over the areas of involvement.

3. Patient History:
- Recent history of trauma or injury to the neck or back.
- Previous episodes of panniculitis or related skin conditions.

4. Associated Symptoms:
- Pain or tenderness in the affected areas.
- Possible systemic symptoms such as fever or malaise.

5. Diagnostic Imaging:
- Imaging studies (e.g., ultrasound, MRI) indicating inflammation or changes in the subcutaneous tissue in the specified regions.

6. Laboratory Findings:
- Elevated inflammatory markers (e.g., ESR, CRP) that correlate with the clinical findings.

7. Exclusion of Other Conditions:
- Ruling out other causes of similar symptoms, such as infections, neoplasms, or autoimmune disorders.

8. Response to Treatment:
- Evaluation of the patient’s response to initial treatment, which may support the diagnosis of panniculitis.

These criteria should be carefully assessed to determine the appropriateness of using the ICD code M5405 in clinical documentation and billing processes.

For the ICD code M54.05, which pertains to panniculitis affecting regions of the neck and back, thoracolumbar 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 joint, subacromial bursa); without ultrasound guidance.

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

4. 97110 - Therapeutic exercises to develop strength and endurance, range of motion, and flexibility (each 15 minutes).

5. 97140 - Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes.

These CPT codes are examples of procedures that might be utilized in the management or treatment of conditions associated with ICD code M54.05. It is important for healthcare providers to select the most appropriate CPT code based on the specific treatment rendered and the clinical scenario.

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