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v1.0.0
ICD-10 Guide
DiagnosesChronic Bilateral Low Back Pain Without Sciatica

Chronic Bilateral Low Back Pain Without Sciatica

ICD-10 Coding for Chronic Bilateral Low Back Pain Without Sciatica(M54.50)

PRIMARY SPECIALTYPrimary Care
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Chronic Bilateral Low Back Pain Without Sciatica?
Essential facts and insights about Chronic Bilateral Low Back Pain Without Sciatica

Key Clinical Considerations:

  • Chronic low back pain lasting more than 3 months
  • Pain is bilateral and does not radiate down the legs (no sciatica)
  • Pain may be described as dull, aching, or throbbing

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history including duration and characteristics of pain
  • Physical examination findings such as tenderness or muscle spasm
  • Assessment of functional limitations and impact on daily activities

Coding Guidelines

Usage Guidelines & Examples

  • Follow usage guidelines for chronic pain coding.
  • Common errors include misclassifying acute pain as chronic.

Code Exclusions

Important Exclusions

  • Acute low back pain (M54.3)
  • Conditions with radiculopathy or sciatica

Related ICD-10 Codes

Primary Codes
M54.5
Chronic low back pain
Ancillary Codes
G89.29
Differential Codes
M54.41
M51.26

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Primary Care

Specialty Applications

  • Adults with chronic low back pain
  • Primary care settings, pain management clinics

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Document the duration, intensity, and impact of pain on daily activities.

What are the billing considerations?

Ensure accurate coding to reflect the chronic nature of the condition for appropriate reimbursement.