Every year, the Centers for Disease Control and Prevention (CMS) publishes updates to the ICD-10 manual, deleting unnecessary codes, adding new ones, and revising language as-needed. Effective October 1, 2021, CMS published its latest round of ICD-10 changes, including new ICD-10 codes for back pain and the deletion of ICD-10 code M54.5. Preparing now can ensure your claims will continue to be paid smoothly.
Here’s a look at some of the changes most relevant to chiropractors:
M54.5 Codes Is No More...
The ICD-10 code - M54.5 - is being deleted as a valid, billable diagnosis code. Providers cannot use this code on or after October 1. Existing patients with the M54.5 diagnosis code will need to be updated to a valid ICD-10 code.
New Codes to Replace M54.5
The current code, M54.5 (Low back pain) has been expanded into three more specific codes:
- M54.50 (Low back pain, unspecified)
- M54.51 (Vertebrogenic low back pain)
- M54.59 (Other low back pain)
zHealthEHR Updated the System with New Codes
When CMS edits the ICD-10 manual, those changes apply to all insurance payers—Medicare, state, and commercial alike. We have updated our billing software so it becomes easy for you to code using the new ICD-10 codes for back pain. M54.5 code will become obsolete but we will keep it in the system for a while.
More code changes from CMS are slated to come down the pipeline with the 2022 final rule. Keep your eyes on our Announcements for the latest information that you need to know.