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Wiki Different reimbursements for low back pain dx code for chiropractic

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Lakewood, NJ
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Hi everyone,

A chiropractor I work with and do billing for mentioned to me today that a friend of his in New York was told there is a higher reimbursement when using code M54.50 as opposed to M54.51 when coding for low back pain. Has anyone else had this experience? I am based in New Jersey and we are out-of-network providers, if that makes a difference. I've been trying to do research on this but the most I could find is to avoid M54.51 as it refers to pain that stems from the vertebral end plate and is not an appropriate code to use for general low back pain. Regardless, we may start using M54.50 anyway based on what I have found, but am wondering if the reimbursement part is true.

Can someone please advise? Thank you!
 
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