ICD-10 · PDGM grouping
M54 Dorsalgia
All 33 codes in the M54 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
33
Can lead a claim
24
Cannot lead a claim
9
What CMS assigns to M54
24 of the 33 codes group to Musculoskeletal Rehabilitation; 9 are assigned no clinical group. None of the 33 is assigned a comorbidity subgroup. 24 of the 33 can lead a claim.
Every code in M54
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| M54.0 Panniculitis affecting regions of neck and back | ||||
| M54.00 | Panniculitis affecting regions of neck and back, site unspecifiedCMS: Panniculitis affecting regions of neck and back, site unsp | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M54.01 | Panniculitis affecting regions of neck and back, occipito-atlanto-axial regionCMS: Panniculitis aff regions of neck/bk, occipt-atlan-ax region | Can lead a claim | E | None |
| M54.02 | Panniculitis affecting regions of neck and back, cervical regionCMS: Panniculitis affecting regions of neck/bk, cervical region | Can lead a claim | E | None |
| M54.03 | Panniculitis affecting regions of neck and back, cervicothoracic regionCMS: Panniculitis aff regions of neck/bk, cervicothor region | Can lead a claim | E | None |
| M54.04 | Panniculitis affecting regions of neck and back, thoracic regionCMS: Panniculitis affecting regions of neck/bk, thoracic region | Can lead a claim | E | None |
| M54.05 | Panniculitis affecting regions of neck and back, thoracolumbar regionCMS: Panniculitis affecting regions of neck/bk, thoracolum region | Can lead a claim | E | None |
| M54.06 | Panniculitis affecting regions of neck and back, lumbar regionCMS: Panniculitis affecting regions of neck/bk, lumbar region | Can lead a claim | E | None |
| M54.07 | Panniculitis affecting regions of neck and back, lumbosacral regionCMS: Panniculitis affecting regions of neck/bk, lumbosacr region | Can lead a claim | E | None |
| M54.08 | Panniculitis affecting regions of neck and back, sacral and sacrococcygeal regionCMS: Panniculitis aff regions of neck/bk, sacr/sacrocygl region | Can lead a claim | E | None |
| M54.09 | Panniculitis affecting regions, neck and back, multiple sites in spineCMS: Panniculitis aff regions, neck/bk, multiple sites in spine | Can lead a claim | E | None |
| M54.1 Radiculopathy | ||||
| M54.10 | Radiculopathy, site unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M54.11 | Radiculopathy, occipito-atlanto-axial region | Can lead a claim | E | None |
| M54.12 | Radiculopathy, cervical region | Can lead a claim | E | None |
| M54.13 | Radiculopathy, cervicothoracic region | Can lead a claim | E | None |
| M54.14 | Radiculopathy, thoracic region | Can lead a claim | E | None |
| M54.15 | Radiculopathy, thoracolumbar region | Can lead a claim | E | None |
| M54.16 | Radiculopathy, lumbar region | Can lead a claim | E | None |
| M54.17 | Radiculopathy, lumbosacral region | Can lead a claim | E | None |
| M54.18 | Radiculopathy, sacral and sacrococcygeal region | Can lead a claim | E | None |
| M54.2 | Cervicalgia | Can lead a claim | E | None |
| M54.3 Sciatica | ||||
| M54.30 | Sciatica, unspecified side | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M54.31 | Sciatica, right side | Can lead a claim | E | None |
| M54.32 | Sciatica, left side | Can lead a claim | E | None |
| M54.4 Lumbago with sciatica | ||||
| M54.40 | Lumbago with sciatica, unspecified side | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M54.41 | Lumbago with sciatica, right side | Can lead a claim | E | None |
| M54.42 | Lumbago with sciatica, left side | Can lead a claim | E | None |
| M54.5 Low back pain | ||||
| M54.50 | Low back pain, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M54.51 | Vertebrogenic low back pain | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M54.59 | Other low back pain | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M54.6 | Pain in thoracic spine | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M54.8 Other dorsalgia | ||||
| M54.81 | Occipital neuralgia | Can lead a claim | E | None |
| M54.89 | Other dorsalgia | Can lead a claim | E | None |
| M54.9 | Dorsalgia, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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