ICD Code M54.4

ICD code M54.4 is low back pain.

1. Presence of pain localized to the lower back region

2. Absence of radiation of pain into the lower extremities

3. No evidence of nerve root involvement (e.g., no numbness, tingling, or weakness in the legs)

4. Pain may be acute or chronic in nature

5. Pain may be associated with muscle stiffness or limited range of motion in the lumbar spine

6. No underlying specific pathology identified (such as fracture, infection, or malignancy)

7. Symptoms may be aggravated by physical activity or prolonged sitting/standing

8. Physical examination reveals localized tenderness in the lumbar area without neurological deficits

Relevant CPT codes that may be used to treat ICD code M54.4 include:

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

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

- 97110 (Therapeutic exercises, each 15 minutes)

- 97112 (Neuromuscular reeducation, each 15 minutes)

- 97140 (Manual therapy techniques, each 15 minutes)

- 99202–99215 (Evaluation and management services, new or established patient)

- 72020 (Radiologic examination, spine, single view, specify level)

- 72100 (Radiologic examination, spine, lumbosacral, 2 or 3 views)

- 97010 (Application of a modality to 1 or more areas; hot or cold packs)

- 97035 (Ultrasound, each 15 minutes)

- 97124 (Massage therapy, each 15 minutes)

See how MD Clarity’s RevFind software can automatically read your payer contracts and identify underpayments for CPT codes associated with ICD code M54.4. Schedule a demo today to ensure you’re capturing every dollar your practice has earned.