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Compare/G89 vs M54.5

G89 vs M54.5

G89 (Pain, not elsewhere classified) compared with M54.5 (Low back pain), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Can these codes be reported together?

Yes, when both are documented. G89 carries an Excludes2 note covering M54.5: “lumbar region pain (M54.5-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Yes, when both are documented. G89 carries an Excludes2 note covering M54.5: “spine pain (M54.-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

G89Pain, not elsewhere classifiedM54.5Low back pain
Billing statusNon-billable header

Report instead: G89.0, G89.11, G89.12, G89.18, G89.21

Non-billable header

Report instead: M54.50, M54.51, M54.59

ClassificationG00-G99 — Diseases of the Nervous System (G00-G99)M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
DefinitionPain, not elsewhere classified is a non-billable ICD-10-CM category code (G89).Low back pain is a non-billable ICD-10-CM category code (M54.5).

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources