Vetebrogenic back pain is specifying the origin of the pain from the vertebrae or spine. However, this code is to distinguish…

Welcome to your billing and coding weekly solutions by American Acupuncture Council Network (AAC).

Are you confused as to which of the 3 new ICD10 low back pain codes to use?

You are not alone!

Today we will focus on the new code M54.51 Vertebrogenic low back pain.

Vetebrogenic back pain is specifying the origin of the pain from the vertebrae or spine. However, this code is to distinguish specific “lower back vertebral endplate pain” and would not be used for simple “spine-related”.

This would be a covered diagnosis but one with specificity of a particular condition.

Spine related conditions such as sprain, strain, radiculopathy, disc, etc. would not be appropriate for this code as they have a more specified code. Veterbrogenic means coming from the bone itself.

Important: For any dates of service on or after 10-1-2021 the new codes must be used and AAC Network has a list of the complete code update.

Remember, billing with incorrect acupuncture CPT and ICD codes can lead to claim rejections and delays in payments, which can have a devastating impact on generating revenue and keeping you in business. 

If you are experiencing insurance claim denial, staff spending too much time trying to get claims paid, and patients asking why their claims have not been paid then American Acupuncture Council Network is your solution.

American Acupuncture Council Network stays ahead of the curve on the latest trends and changes in billing and coding by utilizing their direct channel of communication with the insurance companies and organizations that set the guidelines.

There is a reason acupuncturists have trusted AAC with their business for over 30 years.


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