ICD Code M54.40

ICD code M54.40 is lumbago (lower back pain) with sciatica, but it does not specify whether the pain is on the right or left side.

1. Presence of lower back pain (lumbago)

2. Radiating pain along the sciatic nerve pathway

3. Sciatic pain may extend from the lower back through the buttock and down the leg

4. No specification of whether the symptoms are on the right or left side

5. Absence of more specific underlying causes identified (e.g., trauma, infection, neoplasm)

6. Clinical evaluation confirms both lumbago and sciatica symptoms

7. No documentation of laterality in the medical record

Relevant CPT codes for ICD code M54.40 include:

- 99202–99215 (Evaluation and Management services)

- 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)

- 62321 (Injection(s), of diagnostic or therapeutic substance(s) [e.g., anesthetic, antispasmodic, opioid, steroid]; lumbar or sacral [caudal] epidural, with imaging guidance)

- 62323 (Injection(s), of diagnostic or therapeutic substance(s); lumbar or sacral [caudal] epidural, without imaging guidance)

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

- 97110 (Therapeutic exercises)

- 97140 (Manual therapy techniques)

- 97035 (Ultrasound therapy)

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

- 99217–99220 (Observation care discharge services, if applicable)

- 99281–99285 (Emergency department services, if applicable)

Schedule a demo to see how MD Clarity’s RevFind software can automatically read your contracts and identify underpayments for CPT codes associated with ICD code M54.40. Discover how easy it is to ensure you’re being paid accurately for every service provided.