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ICD-10 Guide
ICD-10 CodesM54.32

M54.32

Billable

Sciatica, left side

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

Code Description

ICD-10 M54.32 is a billable code used to indicate a diagnosis of sciatica, left side.

Key Diagnostic Point:

Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from the lower back through the hips and buttocks and down each leg. Sciatica typically affects only one side of the body, and in this case, it is specifically noted as affecting the left side. The condition is often caused by a herniated disk, bone spur on the spine, or narrowing of the spine (spinal stenosis) that compresses part of the nerve. This can lead to inflammation, pain, and often some numbness in the affected leg. Patients may experience varying degrees of pain, from mild discomfort to severe, debilitating pain that can interfere with daily activities. Conservative management options include physical therapy, anti-inflammatory medications, and corticosteroid injections. In cases where conservative treatment fails, surgical options such as microdiscectomy or laminectomy may be considered to relieve pressure on the sciatic nerve. Accurate diagnosis and management are crucial to prevent chronic pain and improve the quality of life for affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between left-sided and right-sided sciatica
  • Understanding the underlying causes of sciatica
  • Documenting the severity and duration of symptoms
  • Identifying associated conditions such as herniated discs or spinal stenosis

Audit Risk Factors

  • Inadequate documentation of the specific side affected
  • Failure to document conservative treatment attempts
  • Lack of clarity on the underlying cause of sciatica
  • Inconsistent coding of associated conditions

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on physical examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with lower back pain radiating to the left leg, often after an injury or with a history of degenerative disc disease.

Billing Considerations

Ensure that the documentation clearly states the side of sciatica and any associated neurological deficits.

Neurology

Documentation Requirements

Comprehensive neurological examination findings, including sensory and motor function assessments.

Common Clinical Scenarios

Patients with chronic left-sided sciatica presenting with numbness or weakness in the left leg.

Billing Considerations

Document any imaging studies performed and their findings to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use M54.32 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include details about the duration and severity of symptoms, as well as any treatments attempted

Exclusion Criteria

Do NOT use M54.32 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

63030CPT Code

Laminectomy, facetectomy, and foraminotomy

Clinical Scenario

Used when surgical intervention is required for severe sciatica due to nerve compression.

Documentation Requirements

Pre-operative assessment, imaging results, and post-operative follow-up notes.

Specialty Considerations

Orthopedic or neurosurgical documentation must clearly outline the need for surgery.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like sciatica, improving the accuracy of data collection and reimbursement processes. M54.32 provides specificity that was not available in ICD-9, enhancing clinical understanding and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like sciatica, improving the accuracy of data collection and reimbursement processes. M54.32 provides specificity that was not available in ICD-9, enhancing clinical understanding and treatment planning.

Reimbursement & Billing Impact

reimbursement processes. M54.32 provides specificity that was not available in ICD-9, enhancing clinical understanding and treatment planning.

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 M54.32 and M54.30?

M54.32 specifies sciatica affecting the left side, while M54.30 is used when the side is unspecified. Accurate documentation of the affected side is crucial for proper coding.