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

ICD-10 M54.12

Billable / Specific

Radiculopathy, cervical region

M54
Block
0
Synonyms
806
LCDs
38
Payer Policies
8
Linked CPTs

About ICD-10-CM M54.12

ICD-10-CM code M54.12 represents Radiculopathy, cervical region. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M54). The 2026 edition of ICD-10-CM M54.12 became effective on October 1, 2025.

Medicare LCD Coverage for M54.12

Local Coverage Determinations (LCDs) from CMS MACs that list M54.12 as a covered diagnosis.

806 LCDs

Showing top 10 of 806 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 M54.12.

38 policies

2 Cigna

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

5 Medicare

Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Home Health Physical Therapy
Policy ID: ART-53058
Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065
Billing and Coding: Nerve Conduction Studies and Electromyography
Policy ID: ART-54095

CPT Codes Commonly Billed with M54.12

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

8 linkages
  • 72141 MRI cervical spine without contrast — cervicalgia, cervical radiculopathy, cervical disc disorder, spinal stenosis cervical, cervical sprain, spondylosis Radiology
  • 98940 CMT spinal 1-2 regions — low back pain, cervicalgia, somatic dysfunction cervical/thoracic/lumbar/sacral, cervical radiculopathy, lumbosacral neuritis Chiropractic
  • 98941 CMT spinal 3-4 regions — same as 98940, multiple regions Chiropractic
  • 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 M54.12 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
M54.12 7234 10000

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

ICD-10 M54.12, Billing FAQ

Is ICD-10 code M54.12 billable? +

Yes, M54.12 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 M54.12? +

Procedures frequently paired with M54.12 include: 72141, 98940, 98941, 64479, 64484.

What ICD-9 codes does M54.12 map to? +

Per CMS GEMs, M54.12 maps to ICD-9 codes: 7234. 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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