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M54.40 vs M54.42

M54.40 (Lumbago with sciatica, unspecified side) compared with M54.42 (Lumbago with sciatica, left side), from the official CMS tabular data. M54.40 and M54.42 code the same condition on opposite sides.

Relationship

Review

Laterality relationship

M54.40
Unspecified
Lumbago with sciatica, unspecified side
M54.42
Left
Lumbago with sciatica, left side

Same condition; these differ only in which side is documented.

These codes share a category and title and differ only in the side affected. The documentation decides which applies, and a bilateral code is reported only where the code set provides one.

Source: ICD-10-CM tabular list (laterality variant derived from the code title)

Can these codes be reported together?

Same condition, opposite side. M54.40 and M54.42 name the same condition on opposite sides of the body.

Same category and title, differing only in which side is affected — the documentation decides which one applies, and a bilateral code is reported only where the code set provides one.

Side by side

M54.40Lumbago with sciatica, unspecified sideM54.42Lumbago with sciatica, left side
Billing statusBillableBillable
ClassificationM00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
DefinitionLumbago with sciatica, unspecified side is a billable ICD-10-CM diagnosis code (M54.40).Lumbago with sciatica, left side is a billable ICD-10-CM diagnosis code (M54.42).

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