ICD-10 Codes for Physical Medicine and Pain Management

Disclaimer:  The information here is NOT meant to replace the sound advice of a billing and coding expert.

Below is a list of the most common ICD-10 codes (diagnostic codes) used in physical medicine & rehabilitation (PM&R) and interventional pain management clinics.  Obviously, because of the overlap in conditions treated, this list will be handy for orthopedic and rheumatology clinics as well.

Feel free to leave comments in the section below.

Here is a list of the old ICD-9 codes

 

7th position options

  • A = initial visit
  • D = subsequent visit
  • S = sequela of the original injury

Note:  If I list a code as “unspecified”, it usually means there are more specific codes, but I just don’t want to list them all.

Head / Face

  • Atypical facial pain:  G50.1
  • Cervicogenic headache/Suboccipital headache:  R51
  • Cluster headache (not intractable):  G44.009
  • Occipital neuralgia/headache:  M54.81
  • Spinal headache:  G97.1
  • Temporomandibular joint dysfunction (unspecified):  M26.60
  • Tension headache:  G44.209
  • Trigeminal neuralgia:  G50.0

Cervical Spine

  • Cervicalgia (neck pain):  M54.2
  • Degenerative disc disease (cervical)
    • High cervical DDD:  M50.31
    • Mid cervical DDD:  M50.32
    • C7/T1 DDD:  M50.33
  • Disc herniation (cervical):
    • High cervical:  M50.21
    • Mid cervical:  M50.22
    • C7/T1:  M50.23
  • Dystonia / Torticollis:  M43.6
  • Facet syndrome (cervical):  M54.02
  • Failed back syndrome (post-laminectomy) – Cervical:  M96.1
  • Radiculopathy
    • Cervical:  M54.12
    • Cervicothoracic:  M54.13
    • Radic 2/2 disc herniation (high cervical):  M50.11
    • Radic 2/2 disc herniation (mid cervical):  M50.12
    • Radic 2/2 disc herniation (C7/T1):  M50.13
  • Spinal stenosis (cervical):  M48.02
  • Spondylosis (cervical)
    • Spondylosis w/o radiculopathy or myelopathy:  M47.812
    • Spondylosis with radiculopathy (w/o myelopathy):  M47.22
  • Spondylolisthesis – Cervical:  M43.12          Cervicothoracic:  M43.13
  • Sprain of ligaments of cervical spine (whiplash):  S13.4xxA,   S13.4xxD
  • Strain of muscle, fascia, tendons (cervical):  S16.1xxA,   S16.1xxD

Thoracic Spine

  • Back pain (thoracic):  M54.6
  • Compression fracture (pathologic – 2/2 Osteoporosis)
    • Other osteoporosis with current pathological fracture of vertebrae:  M80.88
    • Collapsed vertebrae, not elsewhere classified (Thoracic):  M48.54xA,   M48.54xD
    • Collapseed vertebrae, not elsewhere classified (thoracolumbar):  M48.55xA,   M48.55xD
  • Degenerative disc disease (thoracic):  M51.34
  • Degenerative disc disease (thoracolumbar):  51.35
  • Disc herniation (thoracic):  M51.24
  • Disc herniation (thoracolumbar):  M51.25
  • DISH (Diffuse idiopathic skeletal hyperostosis):  M48.10
  • Failed back syndrome (post-laminectomy) – Thoracic:  M96.1
  • Intercostal neuropathy:  G58.0
  • Radiculopathy (thoracic)
    • Thoracic radic:  M54.14
    • Thoracic radiculopathy 2/2 disc herniation:  M51.14
    • Thoracolumbar radic 2/2 disc herniation:  M51.15
  • Rib sprain:  S23.41xA,  S23.41xD
  • Scoliosis (including kyphoscoliosis):  M41
  • Spinal stenosis (thoracic):  M48.04
  • Spondylosis w/o radic or myelopathy (thoracic):  M47.814
  • Spondylosis with myelopathy (thoracic):  M47.14
  • Sprain of ligaments (thoracic spine):  S23.3xxA,   S23.3xxD
  • Syrinx (syringomyelia):  G95.0
  • Thoracic outlet syndrome (TOS): G54.0

Lumbar Spine

  • Ankylosing spondylitis (of the lumbar spine):  M45.6
  • Arachnoiditis (unspecified meningitis):  G03.9
  • Bertolotti’s syndrome (congenital malformation of spine w/o scoliosis):  Q76.49
  • Compression fracture (pathologic 2/2 Osteoporosis)
    • Age-related osteoporosis with current pathological fracture of vertebrae:  M80.08
    • Collapsed vertebrae, not elsewhere classified – Lumbar:  M48.56xA,  M48.56xD
  • Degenerative disc disease – Lumbar:  M51.36          L/S:  M51.37
  • Disc herniation – Lumbar:  M51.26          L/S:  M51.27
  • Disc herniation with myelopathy – Lumbar:  M51.06
  • Facet syndrome –  Lumbar:  M54.06          L/S:  M54.07
  • Failed back syndrome (post-laminectomy) – Lumbar:  M96.1
  • Iliolumbar syndrome (sprain of lumbar ligaments):  S33.5xxA, S33.5xxD
  • Low back pain (Lumbago):  M54.5
  • Lumbosacral plexopathy:  G54.4
  • Radiculopathy – Lumbar:  M54.16          L/S:  M54.17
  • Radiculopathy 2/2 disc herniation – Lumbar:  M51.16          L/S:  M51.17
  • Spinal stenosis (Central)
    • Lumbar central stenosis with or w/o neurogenic claudication:  M48.06_
    • L/S central stenosis with or w/o neurogenic claudication:  M48.07_
    • Lumbar central stenosis 2/2 disc herniation:  M99.53
  • Spinal stenosis (Foraminal) – Lumbar
    • 2/2 facet joint spurs and spondylolisthesis:  M99.63
    • 2/2 disc bulge & soft tissue:  M99.73
  • Spondylolisthesis – Lumbar:  M43.16          L/S:  M43.17
  • Spondylolysis (and congenital spondylolisthesis):  Q76.2
  • Spondylolysis (acquired):  M43.06
  • Spondylosis w/o myelopathy or radiculopathy – Lumbar:  M47.816          L/S:  M47.817
  • Spasm of back muscles:  M62.830
  • Sprain (lumbar):  S33.5xxA, S33.5xxD
  • Strain (lumbar):  S39.012

Sacrum / Buttocks

  • Cluneal neuroma (neuralgia/neuritis, unspecified):  M79.2
  • Coccydynia (coccyx pain):  M53.3
  • Piriformis syndrome (with sciatica) – LEFT:  G57.02          RIGHT:  G57.01
  • Sacroiliac joint disorder/pain (arthropathy, unspecified):  M12.9 (maybe)
  • Sacroiliac joint sprain:  S33.6xA,  S33.6xD
  • Sacroiliitis:  M46.1
  • Sacral and sacrococcygeal spondylosis:  M47.818  

Pelvis / Hip / Thigh

  • Arthritis (osteoarthritis) of the hip –   LEFT:  M25.752          RIGHT:  M25.751
  • Bursitis – Ischial or ischiogluteal –  LEFT:  M70.72          RIGHT:  M70.71
  • Bursitis – Trochanteric –   LEFT:  M70.62          RIGHT:  M70.61
  • Femoral neuropathy –  LEFT:  G57.22          RIGHT:  G57.21
  • Gluteal tendinitis –   LEFT:  M76.02          M76.01
  • Hamstring strain –   LEFT:  S76.312A          RIGHT:  S76.311A
  • Iliotibial band syndrome –  LEFT:  M76.32          RIGHT:  M76.31
  • Meralgia paresthetica (lateral femoral cutaneous nerve) –   LEFT:  G57.12          RIGHT:  G57.11
  • Pain in the hip –  LEFT:  M25.552          RIGHT:  M25.551
  • Pain in the leg –  LEFT:  M79.605          RIGHT:  M79.604
  • Piriformis syndrome (with sciatica) – LEFT:  G57.02          RIGHT:  G57.01

Knee

  • Arthritis (osteoarthritis) – knee:  715.16
  • Bursitis – prepatellar –   LEFT:  M70.42         RIGHT:  M70.41
  • Bursitis – pes anserine (others) –  LEFT:  M70.52          RIGHT:  M70.51
  • Chondromalacia patella –   LEFT:  M22.42          RIGHT:  M22.41
  • Lateral meniscus tear:  Depends on whether it is the anterior or posterior horn
  • Medial meniscus tear:  Depends on whether it is the anterior or posterior horn
  • Pain – knee –  LEFT:  M25.562          RIGHT:  M25.561
  • Patellar tendinitis –   LEFT:  M76.62          RIGHT:  M76.61
  • Peroneal neuropathy –   LEFT:  S84.12xA          RIGHT:  S84.11xA

Ankle / Foot

  • Achilles tendinitis/bursitis –   LEFT:  M76.62          RIGHT:  M76.61
  • Metatarsalgia –   LEFT:  M77.42          RIGHT:  M77.41
  • Morton’s neuroma –   LEFT:  G57.62          RIGHT:  G57.61
  • Pain in the ankle/foot –   LEFT:  M25.572          RIGHT:  M25.571
  • Plantar fasciitis:  M72.2
  • Tarsal tunnel syndrome –  LEFT:  G57.52          RIGHT:  G57.51

Other Lower Extremity

  • Complex regional pain syndrome type I (CRPS type 1) –  LEFT:  G90.522    RIGHT: G90.521   BILATERAL: G90.523
  • Complex regional pain syndrome type II (CRPS type 2) – causalgia –   LEFT: G57.72     RIGHT: G57.71
  • Phantom limb pain:  G54.6

Shoulder

  • Adhesive capsulitis (frozen shoulder) –   LEFT:  M75.02          RIGHT:  M75.01
  • Bicipital tendinitis –   LEFT:  M75.22          RIGHT:  M75.21
  • Bursitis – Subacromial –   LEFT:  M75.52          RIGHT:  M75.51
  • Bursitis – Scapulothoracic (other shoulder lesions) –   LEFT:  M75.82          RIGHT:  M75.81
  • Impingement of shoulder –   LEFT:  M75.42          RIGHT:  M75.41
  • Labral tear (superior glenoid labral tear) –   LEFT:  S43.432A          RIGHT:  S43.431A
  • Osteoarthritis of shoulder –   LEFT:  M25.712          RIGHT:  M25.711
  • Pain in arm –  LEFT:  M79.602          RIGHT:  M79.601
  • Pain of shoulder – LEFT:  M25.512          RIGHT:  M25.511
  • Paresthesia of skin (anywhere):  R20.2
  • Sprain of Sternoclavicular joint:  S23.420A,  S23.420D
  • Strain of muscle/tendon of the rotator cuff –   LEFT:  S46.012          RIGHT:  S46.011

Elbow

  • Lateral epicondylitis (tennis elbow) –   LEFT:  M77.12          RIGHT:  M77.11
  • Medial epicondylitis (golfer’s elbow) –   LEFT:  M77.02          RIGHT:  M77.01
  • Median neuropathy (other than CTS) –  LEFT:  G56.12          RIGHT:  G56.11
  • Olecranon bursitis –  LEFT:  M70.22          RIGHT:  M70.21
  • Radial neuropathy –  LEFT:  G56.32           RIGHT:  G56.31

Wrist / Hand

  • Carpal tunnel syndrome –  LEFT:  G56.02          RIGHT:  G56.01
  • Cubital tunnel syndrome (ulnar neuropathy) –  LEFT:  G56.22          RIGHT:  G56.21
  • De Quervain’s tenosynovitis (radial styloid tenosynovitis):  M65.4
  • Osteoarthritis of the wrist –   LEFT:  M19.032          RIGHT:  M19.031
  • Osteoarthritis of the hand –   LEFT:  M19.042          RIGHT:  M19.041
  • Trigger finger:  M65.30 [each digit has its own specific code]
  • Wrist drop (acquired) –   LEFT:  M21.332          RIGHT:  M21.331

Other Upper Extremity

  • Complex regional pain syndrome type I (CRPS type 1) –  LEFT:  G90.512    RIGHT:  G90.511     BILATERAL:  G90.513
  • Complex regional pain syndrome type II (CRPS type 2) – Causalgia –  LEFT:  G56.42     RIGHT:  G56.41

Rheumatologic

  • Ankylosing spondylitis (AS):  M45.5 (T/L),  M45.6 (Lumbar),  M45.7 (L/S)
  • Dermatomyositis (unspecified with myopathy):  M33.92
  • Gout (unspecified site):  M10.00
  • Polymyalgia rheumatica (PMR):  M35.3
  • Polymyositis (with myopathy):  M33.22
  • Rheumatoid arthritis (unspecified):  M06.9
  • Systemic lupus erythematosus (unspecified):  M32.9

Psych

  • Anxiety:  F41.1
  • Depression (major depressive disorder, recurrent, unspecified):  F33.9
  • Insomnia (unspecified):  G47.00
  • Restless leg syndrome:  G25.81

EMG/NCS Codes

  • Carpal tunnel syndrome –  LEFT:  G56.02          RIGHT:  G56.01
  • Cubital tunnel syndrome (ulnar neuropathy) –  LEFT:  G56.22          RIGHT:  G56.21
  • Diabetic amyotrophy:  E10.44 (in type I diabetes),  E11.44 (in type II diabetes)
  • Lumbosacral plexopathy:  G54.4
  • Neuralgic amyotrophy (Parsonage-Turner syndrome):  G54.5
  • Neuropathy – drug-induced (chemotherapy):  G62.0
  • Pain in arm –  LEFT:  M79.602          RIGHT:  M79.601
  • Pain in the leg –  LEFT:  M79.605          RIGHT:  M79.604
  • Peripheral neuropathy:  G60.9
  • Radial neuropathy –  LEFT:  G56.32           RIGHT:  G56.31
  • Skin hyperesthesia:  R20.3
  • Skin hypoesthesia:  R20.1
  • Skin paresthesia:  R20.2
  • Tarsal tunnel syndrome –  LEFT:  G57.52          RIGHT:  G57.51
  • Thoracic outlet syndrome (TOS): G54.0

Miscellaneous

  • Atrophy from disuse (unspecified site):  M62.50
  • Chronic pain syndrome:  G89.4
  • Constipation:  K59.01 (slow transit),  K59.09 (opioid-induced)
  • Costochondritis (costochondral junction syndrome):  M94.0
  • Edema:  R60.0 (localized edema),  R60.1 (generalized edema)
  • Fibromyalgia:  M79.1
  • Gait abnormality (unsteadiness on feet):  R26.81
  • Gastroesophageal reflux (GERD):  K21.9
  • Muscle spasm (other):  M62.838
  • Myalgia:  M79.7
  • Muscle weakness (generalized):  M62.81  
  • Obesity:  E66.01 (morbid obesity),  E66.3 (overweight)
  • Osteoporosis (age-related and w/o current fracture):  M81.0
  • Peripheral vascular disease (unspecified):  I73.9
  • Poor balance (difficulty in walking, not elsewhere classified):  R26.2
  • Post-herpetic neuralgia (other postherpetic nervous system involvement):  B02.29
  • Ribs (sprain):  S23.41xA
  • Skin hyperesthesia:  R20.3
  • Skin hypoesthesia:  R20.1
  • Skin paresthesia:  R20.2
  • Testosterone deficiency (testicular hypofunction):  E29.1
  • Vitamin D deficiency (avitaminosis D):  E55.9

8 COMMENTS

  1. hello, I code for rehab in an o/p hospital. Are these code sufficient for that as well. I have a hard time finding the right codes sometimes

  2. We are getting denied by United Healthcare for EMG/NCV when billed with 20550, 20553 with modifier 59. Can you please tell us how to bill these codes together.
    This is the best site yet! Thank you.m

    • You were billing for a ligament injection and trigger point injection in addition to EMG codes? Seems odd. If the doctor is really doing EMG/NCS testing in addition to therapeutic injections, he/she would be better off performing those on a separate visit.

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