ICD Code M54.17

ICD code M5417 is used to identify and classify the medical condition known as radiculopathy in the lumbosacral region. Radiculopathy refers to a condition where one or more nerves are affected and do not work properly, often resulting in pain, weakness, numbness, or difficulty controlling specific muscles. The lumbosacral region pertains to the lower part of the spine, which includes the lumbar vertebrae and the sacrum. This code is crucial for healthcare providers as it helps in accurately documenting the diagnosis, facilitating appropriate treatment plans, and ensuring proper billing and reimbursement processes within the healthcare revenue cycle.

When to use the ICD code for Radiculopathy, lumbosacral region:

1. Presence of Radicular Pain: Patient reports pain that radiates from the lower back into the legs, often following a specific nerve root distribution.

2. Numbness or Tingling: Patient experiences sensory changes such as numbness or tingling in the lower extremities, particularly in the areas corresponding to affected nerve roots.

3. Muscle Weakness: Clinical examination reveals weakness in specific muscle groups innervated by the affected nerve roots, impacting mobility and function.

4. Reflex Changes: Diminished or absent deep tendon reflexes in the lower extremities, indicating nerve root involvement.

5. Positive Straight Leg Raise Test: Reproduction of radicular pain during the straight leg raise test, suggesting nerve root irritation or compression.

6. Imaging Findings: MRI or CT scans show evidence of disc herniation, spinal stenosis, or other structural abnormalities affecting the lumbosacral region.

7. Duration of Symptoms: Symptoms persist for a duration consistent with radiculopathy, typically lasting more than a few weeks.

8. Exclusion of Other Conditions: Other potential causes of lower back pain and leg symptoms, such as muscle strain or peripheral neuropathy, have been ruled out through clinical evaluation.

9. Impact on Daily Activities: The symptoms significantly interfere with the patient's daily activities or quality of life, necessitating medical evaluation and intervention.

10. Response to Conservative Treatment: Lack of improvement with conservative management strategies, such as physical therapy or medication, may warrant further diagnostic coding.

For the ICD code M54.17, which pertains to radiculopathy in the lumbosacral region, the relevant CPT codes that may be used for treatment include:

1. CPT 20552 - Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s).

2. CPT 20553 - Injection(s); single or multiple trigger point(s), 3 or more muscles.

3. CPT 20610 - Arthrocentesis, aspiration and/or injection into a major joint or bursa (e.g., hip, knee, shoulder joint, subacromial bursa).

4. CPT 62322 - Injection(s), of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance.

5. CPT 62323 - Injection(s), of diagnostic or therapeutic substance(s) (e.g., anesthetic, antispasmodic, opioid, steroid), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (i.e., fluoroscopy or CT).

6. CPT 64483 - Injection(s), anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, single level.

7. CPT 64484 - Injection(s), anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, each additional level (List separately in addition to code for primary procedure).

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

9. CPT 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 performed to address the condition associated with ICD code M54.17. It's important for healthcare providers to select the appropriate CPT code based on the specific treatment provided and the clinical scenario.

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