ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 M51.16

Billable / Specific

Intervertebral disc disorders with radiculopathy, lumbar region

M51
Block
0
Synonyms
748
LCDs
42
Payer Policies
9
Linked CPTs

About ICD-10-CM M51.16

ICD-10-CM code M51.16 represents Intervertebral disc disorders with radiculopathy, lumbar region. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M51). The 2026 edition of ICD-10-CM M51.16 became effective on October 1, 2025.

Medicare LCD Coverage for M51.16

Local Coverage Determinations (LCDs) from CMS MACs that list M51.16 as a covered diagnosis.

748 LCDs

Showing top 10 of 748 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98942 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98940 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98941 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98943 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95909 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95887 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95912 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95999 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95910 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95870 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M51.16.

42 policies

3 Cigna

Acupuncture - (CPG024)
Policy ID: CPG024_ACUPUNCTURE
Electrodiagnostic Testing (EMG/NCV) - (CPG129)
Policy ID: CPG129_EMG_NCV_SSEP
Intraoperative Monitoring - (0509)
Policy ID: MM_0509

5 Medicare

Billing and Coding: Bariatric Surgery Coverage
Policy ID: ART-53026
Billing and Coding: Home Health Physical Therapy
Policy ID: ART-53058
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065
Billing and Coding: Nerve Conduction Studies and Electromyography
Policy ID: ART-54095
Billing and Coding: Urine Drug Testing
Policy ID: ART-54799

CPT Codes Commonly Billed with M51.16

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

9 linkages
  • 64483 Transforaminal epidural — low back pain, sciatica, disc herniation Pain Medicine
  • 72148 MRI lumbar spine without contrast — low back pain, lumbago, lumbar radiculopathy, lumbar disc herniation, spinal stenosis, lumbar sprain, spondylosis Radiology
  • 64483 Transforaminal epidural injection lumbar — low back pain, lumbosacral radiculopathy, lumbar disc herniation, nerve root compression, spinal stenosis, spondylosis Pain Management
  • 62322 Interlaminar epidural injection lumbar — low back pain, radiculopathy, cervicalgia, disc herniation, spinal stenosis, spondylosis Pain Management
  • 64479 CMS LCD: Billing and Coding: Epidural Steroid Injections for Pain Management CMS LCD
  • 64484 CMS LCD: Billing and Coding: Epidural Steroid Injections for Pain Management CMS LCD
  • 62321 CMS LCD: Billing and Coding: Epidural Steroid Injections for Pain Management CMS LCD
  • 62323 CMS LCD: Billing and Coding: Epidural Steroid Injections for Pain Management CMS LCD
  • 62320 CMS LCD: Billing and Coding: Epidural Steroid Injections for Pain Management CMS LCD

Convert M51.16 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
M51.16 72293 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 M51.16, Billing FAQ

Is ICD-10 code M51.16 billable? +

Yes, M51.16 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with M51.16? +

Procedures frequently paired with M51.16 include: 64483, 72148, 64483, 62322, 64479.

What ICD-9 codes does M51.16 map to? +

Per CMS GEMs, M51.16 maps to ICD-9 codes: 72293. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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