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2025 ICD-10-CM code M54.50

Low back pain, unspecified.

Use this code when a more specific diagnosis for low back pain is not yet determined. Do not use this code concurrently with codes that describe specific causes of low back pain, such as strains, sprains, or disc disorders.

Medical necessity is established by the presence of lower back pain that impacts the patient's function or quality of life.Further investigation may be necessary to determine the underlying cause and appropriate treatment plan.

The physician is responsible for documenting the location and characteristics of the low back pain, and for ruling out other specific causes of the pain before assigning this code.

In simple words: Unspecified pain in the lower back.

Low back pain, unspecified. Includes: Loin pain, Lumbago NOS

Example 1: A patient presents with general lower back pain of unknown cause. The physician performs an examination but cannot determine a specific diagnosis. The pain is described as a dull ache across the lower back., A patient reports experiencing loin pain that started a week ago. No specific injury or event is associated with the pain. After initial examination, the cause of the pain remains unclear., A patient complains of lumbago without any other specific symptoms or signs. Further investigation is needed to determine the underlying reason for the pain.

Documentation of the location, character, and onset of the lower back pain. Any associated symptoms.Results of any physical examinations or imaging studies.If a more definitive diagnosis is established later, the code should be updated.

** This code is used to document low back pain when a more specific diagnosis cannot be determined.If a more specific diagnosis is made, the code should be updated to reflect the definitive diagnosis.

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