Chiropractic Coding & Compliance Alert

Reader Questions:

Know Your Codes for Low Back Pain in ICD-10

Question: A patient comes in with low back pain and the provider diagnoses a subluxation at the lumber level. The patient also has a sacroiliac sprain and postural lumbar lordosis.

How shall we proceed with coding this scenario under ICD-10?

lWisconsin Subscriber

Answer: The primary diagnosis that shall entail medical necessity should be M99.03 (Segmental and somatic dysfunction of lumber region), which corresponds to our familiar 739.3 (Nonallopathic lesions of lumbar region not elsewhere classified) in ICD-9-CM. You can add the secondary diagnoses:

  • M40.46 (Postural lordosis, lumbar region)
  • S33.6XXA (Sprain of sacroiliac joint, initial encounter).