M54
M54 — Dorsalgia
Non-billable headerICD-10-CM
M54 is a non-billable header ICD-10-CM code for dorsalgia. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- psychogenic dorsalgia (F45.41)
Other codes that can never be billed with M54
These codes carry an Excludes1 note pointing at M54. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading M54 alone.
Risk adjustment
M54 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead M54
9 child codes. Green means billable.
Questions about M54
- Is M54 a billable ICD-10-CM code?
- No. M54 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does M54 sit in the tabular list?
- Diseases of the musculoskeletal system and connective tissue (M00-M99), in the block Other dorsopathies (M50-M54).
- What cannot be coded together with M54?
- M54 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.