Wiki low back pain radiating to leg - ICD-10 Code for Low back pain

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Code: M54.5

Code Name: ICD-10 Code for Low back pain

Block: Other dorsopathies (M50-M54)

Details: Low back pain
Loin pain
Lumbago NOS

Excludes 1: low back strain (S39.012)
lumbago due to intervertebral disc displacement (M51.2-)
lumbago with sciatica (M54.4-)
M54
Excludes1: psychogenic dorsalgia (F45.41)

Guidelines: Diseases of the musculoskeletal system and connective tissue (M00-M99)

Note: Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition

Excludes 2: arthropathic psoriasis (L40.5-)
certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
compartment syndrome (traumatic) (T79.A-)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

For more details on M54.5, ICD-10 Code for Low back pain, visit: https://coder.aapc.com/icd-10-codes/M54.5

ggparker14

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Which dx would be more appropriate for low back pain radiating to leg, 724.2 or 724.4?

Thanks for any help.
 

maudys

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724.2 and 729.5? unless they have disc disease and then you would just use that, possibly with acute or chronic pain, depending on the documentation.
 

preserene

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Sciatica is low back pain radiating to the legs- 724.3.

Technically speaking, sciatica is a symptom not a diagnosis It is a non-specific term commonly used to describe symptoms of pain radiating downward from the buttock over the posterior or lateral side of the lower limb.
Where does that pain come from:
Sciatica is pain running down your leg in a pattern determined by the sciatic nerve. The pain often starts in the low back - (due to a herniated disc) - or in the buttock - (due to piriformis syndrome) - and extends as far as your toes. It can be accompanied by numbness, 'pins and needles' ("paresthesias") or, in more severe cases, actual weakness affecting the ankle or toes may accompany the sciatica.
Sciatica is a form of pain that is called a "radiculopathy" in medical terminology. This means that it often follows the path of a single spinal nerve root such as the Lumbar 5 (L5) or Sacral 1 (S1). This is often the case when sciatica is due to a herniated disc or bulging disc. If the cause is in the lumbar spine, the sciatica - or leg pain - is often accompanied by back pain.
 

preserene

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You could place a query to the physicain as regards to this because it is medically known fact that it is sciatica which causes both these symptoms. If the physician does not agree, then you can ask for 724.4 which is radicular syndrome of lower limbs. Then again the documentation should have the terminology of Radiculopathy/ radicular syndrome which not there but it is "simply as low back pain radiating to the lower limbs"
Either way, be it 724.3 or 734.4 , it is not documented in the physician documentation/nor with the descriptive language.
So as such, one can not claim the merits of assigning the better code the payers may pay for either, though.

Best is to query the physician with these two codes selection which one would be the best as per the patient condition.
But one thing radicularpathy/syndrome is a terminology used for Sciatica , not abad choice though ?!!.
Really, doctors could have been more specific in their documentation in such pitfall scenario of coding diellemma.
Thank you good point, to ponder!!!
 
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