ICD Code M54.2

ICD code M54.2 is used to identify and classify the condition known as cervicalgia, which refers to neck pain. This code is utilized by healthcare providers to document and communicate the diagnosis of neck pain for billing, treatment planning, and statistical purposes.

1. Neck Pain: Persistent or recurrent pain localized in the cervical region, often described as aching, sharp, or throbbing.

2. Stiffness: Limited range of motion in the neck, making it difficult to turn the head or perform daily activities.

3. Muscle Spasms: Involuntary contractions of the neck muscles, which may cause discomfort or pain.

4. Tenderness: Sensitivity to touch or pressure in the neck area, often felt when palpating the cervical spine or surrounding muscles.

5. Headaches: Occurrence of headaches that may originate from or be exacerbated by neck pain, often referred to as cervicogenic headaches.

6. Radiating Pain: Pain that may extend from the neck to the shoulders, arms, or upper back, indicating possible nerve involvement.

7. Postural Strain: Pain or discomfort that worsens with prolonged poor posture, such as sitting at a desk or looking down at a phone for extended periods.

8. History of Trauma: Previous neck injury or trauma, such as whiplash, that may contribute to ongoing cervical pain.

9. Degenerative Changes: Evidence of degenerative changes in the cervical spine, such as osteoarthritis or disc degeneration, identified through imaging studies.

10. Exclusion of Other Conditions: Rule out other potential causes of neck pain, such as infections, tumors, or systemic diseases, to confirm the diagnosis of cervicalgia.

For the ICD code M54.2, which is associated with cervicalgia, the relevant CPT codes that may be applicable for treatment include:

1. 99201-99215: Evaluation and Management (E/M) services, which cover office or other outpatient visits.

2. 97110: Therapeutic exercises to develop strength and endurance, range of motion, and flexibility.

3. 97140: Manual therapy techniques, such as mobilization/manipulation, manual lymphatic drainage, and manual traction.

4. 97010: Application of a modality to one or more areas; hot or cold packs.

5. 97035: Ultrasound therapy.

6. 97112: Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception.

7. 20552: Injection(s); single or multiple trigger point(s), one or two muscle(s).

8. 20610: Arthrocentesis, aspiration, and/or injection into a major joint or bursa.

These CPT codes are commonly used in conjunction with the diagnosis of cervicalgia to document and bill for the various treatments and services provided to patients. It is important to ensure that the selected CPT codes accurately reflect the services rendered and are supported by the patient's medical record.

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