2021 ICD-10 Updates

October 12, 2021   |   Evidence in Integrative Healthcare

On October 1, 2021 ICD-10 code M54.5 was decommissioned. In its place, providers may use the following new ICD-10 codes with a fifth character, for dates of service on or after October 1, 2021:

  • M54.50 Low back pain, unspecified
  • M54.51 Vertebrogenic low back pain
  • M54.49 Other low back pain

When selecting an ICD-10 code, it is best to use the most specific code that applies – for example, there are codes for strains/sprains, disc problems, etc. One welcome addition to the list is G44.86 for cervicogenic headaches. This is a common condition treated by integrative healthcare providers and in this case, allows the provider to be more specific about the cause of the headache being treated.

Claims submitted to payers for dates of service on or after October 1, 2021 will need to use the new codes; claims containing the M54.5 code may be denied. Providers are encouraged to check with their payers regarding decommissioned codes and replacements.

More information about ICD-10 updates are available through the Centers for Disease Control and Prevention (CDC), The Centers for Medicare and Medicaid Services (CMS), and various publications.