ICD-10 Code for Sciatica M54.3

What is Sciatica?

Sciatica refers to pain radiating alongside the sciatic nerve’s pathway, originating from the decreased lower back and increasing via the hips, buttocks, and down the legs. It isn’t a disease but a symptom of an underlying circumstance affecting the sciatic nerve.

ICD-10 Code M54.3: Definition

ICD-10 Code M54.3 is exact for diagnosing Sciatica, but it’s a non-billable code, which means it cannot be used for repayment purposes in its standalone form. This code has changed its corresponding ICD-9 code, 724.3.

Key highlights:

Billable: No
ICD-9 Code Transition: 724.3

Symptoms of Sciatica

Patients diagnosed with sciatica often experience:

Sharp, radiating pain: Typically in the lower back, buttocks, or down one leg.
Numbness or tingling: Affecting the leg or foot.
Muscle weakness: Particularly in the affected leg or foot.
Pain triggers: Sudden movements such as coughing, sneezing, or prolonged sitting can worsen symptoms.

Common Causes of Sciatica

Herniated or Bulging Discs: Disc material compresses the sciatic nerve.
Spinal Stenosis: Narrowing of the spinal canal leading to nerve compression.
Pisiforms Syndrome: The pisiforms muscle irritates the sciatic nerve.
Degenerative Disc Disease: Age-related wear affecting the spinal discs.
Trauma or Injuries: Fractures or dislocations impacting the nerve.

Dual Diagnoses

When sciatica is secondary to another condition, proper coding is essential:

Primary diagnosis: Use the ICD-10 code for the root condition (e.g., herniated disc: M51.16).
Secondary diagnosis: Use M54.3 to highlight the sciatica symptoms.

Similar ICD-10 Codes

M54.4x: Low back pain with sciatica (side-specific).
M51.1x: Intervertebral disc disorders causing sciatica-like symptoms.
M54.5: General Low back pain without radiculopathy.

General ICD-10 Insights

The ICD-10 device, maintained by the World Health Organization (WHO), allows healthcare providers to code and diagnose diverse conditions exactly. As the updated successor to ICD-9, ICD-10 provides extended classifications with over 70,000 codes and is mandatory under HIPAA for providers within the United States.

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