ICD-10 M99.04
Billable / SpecificSegmental and somatic dysfunction of sacral region
About ICD-10-CM M99.04
ICD-10-CM code M99.04 represents Segmental and somatic dysfunction of sacral region. This is a billable/specific code in the Musculoskeletal and Connective Tissue chapter (block M99). The 2026 edition of ICD-10-CM M99.04 became effective on October 1, 2025.
Medicare LCD Coverage for M99.04
Local Coverage Determinations (LCDs) from CMS MACs that list M99.04 as a covered diagnosis.
Showing top 10 of 27 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing M99.04.
2 Cigna
5 Medicare
CPT Codes Commonly Billed with M99.04
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 97140 Manual therapy — back pain, neck pain, joint pain, myalgia, spasm, muscle weakness, impingement, somatic dysfunction, chronic pain, spondylosis Physical Therapy
- 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
- 98942 CMS LCD: Billing and Coding: Chiropractic Services CMS LCD
- 27279 CMS LCD: Billing and Coding: Minimally Invasive Arthrodesis of the Sacroiliac Joint (SIJ) CMS LCD
- 27278 CMS LCD: Billing and Coding: Minimally Invasive Arthrodesis of the Sacroiliac Joint (SIJ) CMS LCD
- 98929 CMS LCD: Billing and Coding: Osteopathic Manipulative Treatment CMS LCD
- 98927 CMS LCD: Billing and Coding: Osteopathic Manipulative Treatment CMS LCD
- 98928 CMS LCD: Billing and Coding: Osteopathic Manipulative Treatment CMS LCD
- 98925 CMS LCD: Billing and Coding: Osteopathic Manipulative Treatment CMS LCD
Convert M99.04 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| M99.04 | 7394 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To M99.04
Other codes in section M99 (Biomechanical lesions, not elsewhere classified).
ICD-10 M99.04, Billing FAQ
Is ICD-10 code M99.04 billable? +
Yes, M99.04 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 M99.04? +
Procedures frequently paired with M99.04 include: 97140, 98940, 98941, 98942, 27279.
What ICD-9 codes does M99.04 map to? +
Per CMS GEMs, M99.04 maps to ICD-9 codes: 7394. 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 June 2, 2026.
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