ICD-10 M54.50
Billable / SpecificLow back pain, unspecified
About ICD-10-CM M54.50
ICD-10-CM code M54.50 represents Low back pain, unspecified. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M54). The 2026 edition of ICD-10-CM M54.50 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under M54.50. Per CMS ICD-10-CM Tabular 2026.
- Loin pain
- Lumbago NOS
Medicare LCD Coverage for M54.50
Local Coverage Determinations (LCDs) from CMS MACs that list M54.50 as a covered diagnosis.
Showing top 10 of 65 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing M54.50.
4 Aetna
4 Cigna
5 Medicare
CPT Codes Commonly Billed with M54.50
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 99203 New patient office visit — common complaints plus chronic conditions: HTN, diabetes, hyperlipidemia, asthma, GERD, back pain, migraine, tachycardia, prediabetes Primary Care
- 99204 New patient office visit — multiple chronic conditions: HTN, T2DM, hyperlipidemia, asthma, anxiety, depression, obesity, IBS, COPD, thyroid, anemia, CAD, sleep apnea, psoriasis, RA Primary Care
- 99213 Established patient — HTN follow-up, diabetes management, hyperlipidemia, asthma, anxiety, common complaints, back pain, GERD, migraine, acne, joint pain, prediabetes, obesity, anemia, hypothyroid, fatigue Primary Care
- 99214 Established patient — moderate complexity: uncontrolled HTN, diabetes with complications, multiple chronic conditions, COPD, AFib, CKD, sleep apnea, chronic pain, depression Primary Care
- 72148 MRI lumbar spine without contrast — low back pain, lumbago, lumbar radiculopathy, lumbar disc herniation, spinal stenosis, lumbar 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
Codes Adjacent To M54.50
Other codes in section M50-M54 (Other dorsopathies).
ICD-10 M54.50, Billing FAQ
Is ICD-10 code M54.50 billable? +
Yes, M54.50 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to M54.50? +
ICD-10 M54.50 includes: Loin pain; Lumbago NOS.
What CPT codes are commonly billed with M54.50? +
Procedures frequently paired with M54.50 include: 99203, 99204, 99213, 99214, 72148.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 16, 2026.
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