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ICD-10 Guide
ICD-10 CodesM54.17

M54.17

Billable

Radiculopathy, lumbosacral region

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M54.17 is a billable code used to indicate a diagnosis of radiculopathy, lumbosacral region.

Key Diagnostic Point:

Radiculopathy in the lumbosacral region refers to a condition where nerve roots in the lower back are compressed or irritated, leading to pain, weakness, or numbness that radiates down the legs. This condition is often associated with herniated discs, spinal stenosis, or degenerative disc disease. Patients typically present with dorsalgia (back pain) and may experience sciatica, characterized by pain that follows the path of the sciatic nerve. The pain can vary in intensity and may be accompanied by sensory changes or motor deficits. Diagnosis is primarily clinical, supported by imaging studies such as MRI or CT scans to identify the underlying cause of nerve root compression. Treatment options range from conservative management, including physical therapy, medications, and epidural steroid injections, to surgical interventions like discectomy or laminectomy when conservative measures fail. The choice of management depends on the severity of symptoms, duration of pain, and the patient's overall health status.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for precise documentation of neurological deficits
  • Differentiation from other types of back pain
  • Potential for multiple underlying causes

Audit Risk Factors

  • Inadequate documentation of neurological examination findings
  • Failure to document conservative treatment attempts before surgery
  • Misclassification of radiculopathy severity
  • Lack of imaging studies to support diagnosis

Specialty Focus

Medical Specialties

Orthopedic Surgery

Documentation Requirements

Detailed surgical notes, imaging results, and pre-operative assessments.

Common Clinical Scenarios

Patients presenting with severe radicular pain requiring surgical intervention.

Billing Considerations

Ensure documentation reflects the necessity of surgery based on conservative treatment failures.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive treatment plans, progress notes, and response to therapy.

Common Clinical Scenarios

Patients undergoing rehabilitation for radiculopathy with conservative management.

Billing Considerations

Documenting functional improvements and ongoing assessments is crucial for coding.

Coding Guidelines

Inclusion Criteria

Use M54.17 When
  • Follow official ICD
  • CM coding guidelines, ensuring accurate documentation of the patient's symptoms, diagnostic imaging results, and treatment plans
  • Include any relevant co
  • morbidities that may affect treatment

Exclusion Criteria

Do NOT use M54.17 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

63030CPT Code

Laminectomy, facetectomy, and foraminotomy

Clinical Scenario

Used in surgical treatment of lumbosacral radiculopathy.

Documentation Requirements

Operative report detailing the procedure and indications.

Specialty Considerations

Orthopedic surgeons must document the rationale for surgical intervention.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of radiculopathy, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of treatment outcomes and healthcare utilization.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of radiculopathy, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of treatment outcomes and healthcare utilization.

Reimbursement & Billing Impact

reimbursement processes. It has also facilitated better tracking of treatment outcomes and healthcare utilization.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between M54.17 and M54.15?

M54.17 specifically refers to radiculopathy in the lumbosacral region, while M54.15 refers to radiculopathy in the lumbar region without specifying the lumbosacral area.