tci ED Coding & Reimbursement Alert - 2024 Issue Q2

Reader Questions: Use NOS Code for Backache Dx

Question: If a patient is diagnosed with “backache” and there is no other information, how should I choose a diagnosis code for the condition? Florida Subscriber Answer: Your provider isn’t giving you much to go on with that diagnosis; fortunately, there is a code that represents this nebulous description: M54.9 (Dorsalgia, unspecified). Although “backache” isn’t in the descriptor, the alternate terms below the descriptor list the following as codeable with M54.9: Backache NOS Back pain NOS.   ...

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