Orthopedic Coding Alert

Reader Questions:

Look for Combo Code for This Common 2-Condition Dx

Question: If a patient has lumbago and sciatica, should I report each condition separately? Or is there a combination code for this condition?

New Jersey Subscriber

Answer: Actually, there is a diagnosis code that encompasses lumbago and sciatica. Choose one of the following codes to represent lumbago and sciatica, depending on encounter specifics:

  • M54.40 (Lumbago with sciatica, unspecified side)
  • M54.41 (Lumbago with sciatica, right side)
  • M54.42 (Lumbago with sciatica, left side).