ICD-10 Code for Sciatica M54.3
What is Sciatica?
Sciatica refers to pain that travels along the sciatic nerve, which extends from the lower back through the hips, backsides, and down each leg.
It is not a disease but a symptom of an original condition that affects the sciatic nerve.
ICD-10 Code M54.3: Definition
ICD-10 Code M54.30 is used for diagnosing sciatica when the affected side is not specified. It is classified under dorsal is, which refers to disorders of the spine and back. However, this code is billable, meaning it cannot be used independently for insurance reimbursement.
Key Highlights:
- Billable: Billable
- Classification: Musculoskeletal system and connective tissue disorders
- Related Codes:31 (Sciatica, right side), M54.32 (Sciatica, left side)
Symptoms of Sciatica
People with M54.30 sciatica often experience:
- High-pitched, shooting pain in the lower back, backside, or down one leg
- Coldness or scratch on the leg or foot
- Muscle weakness in the affected leg
- Pain triggers such as prolonged sitting, sudden movements, or sneezing
Common Causes of Sciatica
Many conditions can lead to dx M54.30 sciatica, including:
- Herniated Discs: A bulging or ruptured disc pressing on the sciatic nerve
- Spinal Stenosis: Contraction of the spinal canal leads to nerve compression
- Performs Syndrome: A tight or inflamed pisiform muscle irritating the sciatic nerve
- Degenerative Disc Disease: Age-related wear and tear affecting spinal discs
- Injuries or Trauma: Fractures, dislocations, or accidents impacting the nerve
Dual Diagnoses
When M54.30 is a secondary condition, proper coding is crucial:
- Primary diagnosis: The root cause (e.g., herniated disc: M51.16)
- Secondary diagnosis: 30 to indicate sciatica symptoms
Similar ICD-10 Codes
- M54.31: Sciatica, right side
- M54.32: Sciatica, left side
- M54.40: Lumbago with sciatica, unspecified side
- M54.5: General Low back pain
General ICD-10 Insights
the ICD-10 system, maintained by the World Health Organization (WHO), provides a comprehensive classification for medical diagnoses.
It replaced ICD-9 and is mandatory for healthcare providers under HIPAA regulations in the United States. For instance, the ICD-9 code for M54.30 was previously aligned with 724.3 before the transition.
