ICD-10 code for spine pain

The ICD-10-CM code for spine pain is M54.9 (Dorsalgia, unspecified). The official index lists 4 more specific codes, so check the documentation for details such as type, cause, site or severity before settling on M54.9.

Within M54, choose M54.9 (unspecified) only when documentation doesn't support a more specific option: panniculitis affecting regions of neck and back (M54.0), radiculopathy (M54.1), Cervicalgia (M54.2), sciatica (M54.3), Lumbago with sciatica (M54.4), low back pain (M54.5), pain in thoracic spine (M54.6) and other dorsalgia (M54.8).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

In MS-DRG v44.0, it is part of the grouping logic for DRG 551 (Medical Back Problems with MCC, relative weight 1.6358) and DRG 552 (Medical Back Problems without MCC, relative weight 0.9584), in MDC 08 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.