Is M54.2 a billable ICD-10-CM code?

Yes. M54.2 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does M54.2 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 M54.2?

M54.2 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

M54.2

M54.2 — Cervicalgia

Billable / specific codeICD-10-CM

M54.2 is a billable, specific ICD-10-CM code for cervicalgia. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

cervicalgia due to intervertebral cervical disc disorder (M50.-)

Risk adjustment

M54.2 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.

Medicare coverage

M54.2 is named in 57 Medicare coverage policies — 46 listing it as supporting medical necessity, and 11 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57701Billing and Coding: Trigger Point Injections (TPI)not covered
A58865Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
A58893Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered
A59374Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Woundnot covered

How M54.2 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to M54.2.

Cervicalgia
Pain›neck NEC
Pain›spine›cervical

Related codes at this level

Codes that share M54. If M54.2 is not quite right, the correct code is usually one of these.

Questions about M54.2

Is M54.2 a billable ICD-10-CM code?: Yes. M54.2 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does M54.2 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 M54.2?: M54.2 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.