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Compare/M54.3 vs M54.4

M54.3 vs M54.4

M54.3 (Sciatica) compared with M54.4 (Lumbago with sciatica), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.

Can these codes be reported together?

No — do not report together. M54.3 carries an Excludes1 note covering M54.4: “sciatica with lumbago (M54.4-)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Side by side

M54.3SciaticaM54.4Lumbago with sciatica
Billing statusNon-billable header

Report instead: M54.30, M54.31, M54.32

Non-billable header

Report instead: M54.40, M54.41, M54.42

ClassificationM00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
DefinitionSciatica is a non-billable ICD-10-CM category code (M54.3).Lumbago with sciatica is a non-billable ICD-10-CM category code (M54.4).
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Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources