ICD Code M54.42

ICD code M54.42 is used to identify the medical condition known as "Lumbago with sciatica, left side." This code is part of the International Classification of Diseases (ICD) system, which is used by healthcare providers to classify and code all diagnoses, symptoms, and procedures. Specifically, M54.42 indicates that the patient is experiencing lower back pain (lumbago) that is accompanied by sciatica, a condition where pain radiates along the path of the sciatic nerve, which runs down one or both legs from the lower back. In this case, the pain and associated symptoms are affecting the left side of the body. This code helps in accurately documenting the patient's condition for treatment, billing, and statistical purposes.

When to use the ICD code for lumbago with sciatica, left side:

1. Presence of Low Back Pain
- Patient reports persistent or acute pain in the lower back region.

2. Radiating Pain
- Pain radiates from the lower back down the left leg, following the path of the sciatic nerve.

3. Numbness or Tingling
- Patient experiences numbness, tingling, or a "pins and needles" sensation in the left leg or foot.

4. Muscle Weakness
- Weakness in the left leg, making it difficult to move or bear weight.

5. Aggravation of Symptoms
- Symptoms worsen with certain movements, such as bending, lifting, or prolonged sitting.

6. Relief with Positioning
- Patient finds relief when changing positions, such as lying down or elevating the legs.

7. Duration of Symptoms
- Symptoms have persisted for a specific duration, typically more than a few days, indicating a chronic condition.

8. Exclusion of Other Conditions
- Other potential causes of back pain and sciatica have been ruled out through clinical evaluation or imaging studies.

9. Impact on Daily Activities
- The condition significantly affects the patient's ability to perform daily activities or work-related tasks.

10. Previous Episodes
- Patient has a history of similar episodes of low back pain or sciatica, indicating a recurring issue.

For the ICD code M54.42, which pertains to lumbago with sciatica on the left side, the relevant CPT codes that may be applicable for treatment include:

1. 99201-99205 - Office or other outpatient visit for the evaluation and management of a new patient.

2. 99211-99215 - Office or other outpatient visit for the evaluation and management of an established patient.

3. 20552 - Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s).

4. 20553 - Injection(s); single or multiple trigger point(s), 3 or more muscles.

5. 20610 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa.

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

7. 97110 - Therapeutic exercises to develop strength and endurance, range of motion, and flexibility.

8. 97140 - Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes.

9. 97032 - Application of a modality to one or more areas; electrical stimulation (manual), each 15 minutes.

These CPT codes are commonly used in the treatment and management of conditions associated with lumbago and sciatica, and healthcare providers should select the most appropriate codes based on the specific services rendered. Always ensure that the chosen CPT codes align with the services provided and are supported by proper documentation.

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