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

ICD-10 M54.2

Billable / Specific

Cervicalgia

M54
Block
0
Synonyms
1,346
LCDs
49
Payer Policies
12
Linked CPTs

About ICD-10-CM M54.2

ICD-10-CM code M54.2 represents Cervicalgia. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M54). The 2026 edition of ICD-10-CM M54.2 became effective on October 1, 2025.

Type 1 Excludes

Pure excludes, these codes can never be coded together with M54.2. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • cervicalgia due to intervertebral cervical disc disorder (M50.-)

Medicare LCD Coverage for M54.2

Local Coverage Determinations (LCDs) from CMS MACs that list M54.2 as a covered diagnosis.

1,346 LCDs

Showing top 10 of 1,346 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 19300 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 15877 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 19371 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 19380 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 30468 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 30400 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 19396 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 30435 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 30465 →
CMS LCD: Billing and Coding: Cosmetic and Reconstructive Surgery
Article ID: 58573, Effective: 2025-11-17 00:00:00, 137 covered, 1 non-covered
CPT 30462 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing M54.2.

49 policies

2 Aetna

Orthopedic Casts, Braces and Splints - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0009
Back Pain - Invasive Procedures - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0016

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: 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: Urine Drug Testing
Policy ID: ART-54799

CPT Codes Commonly Billed with M54.2

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

12 linkages
  • 64493 Facet injection — back pain, spondylosis Pain Medicine
  • 64635 Facet neurolysis — chronic back pain Pain Medicine
  • 72141 MRI cervical spine without contrast — cervicalgia, cervical radiculopathy, cervical disc disorder, spinal stenosis cervical, cervical sprain, spondylosis Radiology
  • 97110 Therapeutic exercises — back pain, neck pain, joint pain, rotator cuff, knee OA, limb pain, meniscal tear, shoulder injury, ankle sprain, hemiplegia, paraplegia, post joint replacement, muscle weakness Physical Therapy
  • 97140 Manual therapy — back pain, neck pain, joint pain, myalgia, spasm, muscle weakness, impingement, somatic dysfunction, chronic pain, spondylosis Physical Therapy
  • 97035 Ultrasound therapy — myalgia, spasm, back pain, neck pain, joint pain, impingement, epicondylitis, plantar fasciitis Physical Therapy
  • 97161 PT evaluation low complexity — back pain, neck pain, joint pain, rotator cuff, meniscal tear, ankle sprain, limb pain, knee OA, weakness Physical Therapy
  • 97162 PT evaluation moderate complexity — same plus post-fracture, post-replacement, hemiplegia Physical Therapy
  • 62322 Interlaminar epidural injection lumbar — low back pain, radiculopathy, cervicalgia, disc herniation, spinal stenosis, spondylosis Pain Management
  • 98940 CMT spinal 1-2 regions — low back pain, cervicalgia, somatic dysfunction cervical/thoracic/lumbar/sacral, cervical radiculopathy, lumbosacral neuritis Chiropractic

Convert M54.2 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
M54.2 7231 00000

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

ICD-10 M54.2, Billing FAQ

Is ICD-10 code M54.2 billable? +

Yes, M54.2 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for M54.2? +

Type 1 Excludes (never code together with M54.2): cervicalgia due to intervertebral cervical disc disorder (M50.-)

What CPT codes are commonly billed with M54.2? +

Procedures frequently paired with M54.2 include: 64493, 64635, 72141, 97110, 97140.

What ICD-9 codes does M54.2 map to? +

Per CMS GEMs, M54.2 maps to ICD-9 codes: 7231. 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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