2025 ICD-10-CM code M54.51
(Active) Effective Date: N/A Dorsopathies - Other dorsopathies Diseases of the musculoskeletal system and connective tissue (M00-M99) Feed
Vertebrogenic low back pain. Low back vertebral endplate pain.
Medical necessity must be established by demonstrating that the low back pain is caused by damage or changes to the vertebral endplates.
Clinicians, including physicians, therapists, and other healthcare professionals involved in diagnosing and treating musculoskeletal conditions, are responsible for accurately assessing and coding vertebrogenic low back pain.
- Diseases of the musculoskeletal system and connective tissue (M00-M99)
- Dorsopathies (M40-M54)Other dorsopathies (M50-M54)
In simple words: Low back pain caused by damage to the bones of your spine.
Vertebrogenic low back pain is pain originating from the vertebral column, specifically related to the vertebral endplates.
Example 1: A 50-year-old patient presents with chronic low back pain, with imaging revealing Modic changes in the vertebral endplates. The pain is aggravated by prolonged sitting and physical activity.This scenario points to vertebrogenic low back pain, and M54.51 is the appropriate code., A patient experiences a deep, burning pain in their lower back following a minor fall. Imaging studies show damage to the vertebral endplates. This indicates vertebrogenic low back pain, making M54.51 the correct code., A patient with a history of obesity and physically demanding work complains of persistent lower back pain. Diagnostic imaging confirms the presence of vertebral endplate degeneration. This suggests vertebrogenic low back pain, thus M54.51 would be used.
Documentation should include detailed descriptions of the patient's pain characteristics, including location, quality, and exacerbating/relieving factors. Imaging findings, such as Modic changes or other endplate abnormalities, should also be documented.
- Payment Status: Active
- Specialties:Pain Management, Orthopedics, Physical Medicine and Rehabilitation, Family Medicine
- Place of Service:Office, Inpatient Hospital, On Campus-Outpatient Hospital,Outpatient Hospital, etc.