M54.5 vs S39.012
M54.5 (Low back pain) compared with S39.012 (Strain of muscle, fascia and tendon of lower back), 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. M54.5 carries an Excludes1 note covering S39.012: “low back strain (S39.012)”
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
| M54.5Low back pain | S39.012Strain of muscle, fascia and tendon of lower back | |
|---|---|---|
| Billing status | Non-billable header | Non-billable header |
| Classification | M00-M99 — Diseases of the Musculoskeletal System and Connective Tissue (M00-M99) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Low back pain is a non-billable ICD-10-CM category code (M54.5). | Strain of muscle, fascia and tendon of lower back is a non-billable ICD-10-CM category code (S39.012). |
| 7th character | — | The appropriate 7th character is to be added to each code from category S39 |
| Includes | — | injuries to the abdominal wall injuries to the anus injuries to the buttock injuries to the external genitalia |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources