Neurology & Pain Management Coding Alert

You'll specify anatomic sites with ICD-10.

Lumbago and sciatica are two common diagnoses in pain management practices. As you prepare to shift from ICD-9 to ICD-10 in October 2013, mark these conditions as two that will affect your reporting slightly, but not in extensive ways.

ICD-9: Currently, ICD-9-CM has two separate codes for the conditions: 724.2 (Lumbago) and 724.3 (Sciatica). Neither code indicates laterality.

ICD-10 change: When ICD-10 goes into effect, you'll add a third primary code to your options, plus have fifthdigit options designating anatomic laterality. The three main codes will be:

• M54.5 -- Low back pain
• M54.3x -- Sciatica
• M54.4x -- Lumbago with sciatica.

Fifth-digit allocations for M54.3x and M54.4x will be 0 for unspecified side; 1 for right side; and 2 for left side. You'll find the codes in ICD-10's Chapter 13 (Diseases of the Musculoskeletal System and Connective Tissue), subsection/block Other Dorsopathies.

Preparation: When preparing for ICD-10, remember to include all three diagnosis codes on your superbill with choices for the fifth-digit classification when needed. Help your providers learn to specify right versus left anatomic location and to differentiate between lumbago, sciatica, or a combination of the two so you can code more accurately.