ICD Code M54.2

ICD code M54.2 is used to identify the medical condition known as cervicalgia, which refers to neck pain. This code is part of the International Classification of Diseases (ICD) system, which is used by healthcare providers to classify and code all diagnoses, symptoms, and procedures. Cervicalgia specifically denotes pain localized to the cervical region, which is the area of the spine that comprises the neck. This condition can result from various causes, including muscle strain, poor posture, or underlying medical conditions such as arthritis. Proper coding of cervicalgia is crucial for accurate medical billing and ensuring that healthcare providers receive appropriate reimbursement for their services.

When to use the ICD code for Cervicalgia:

1. Presence of Neck Pain: The patient reports pain localized in the cervical region.

2. Duration of Symptoms: Symptoms have persisted for a specific duration, typically more than a few days.

3. Exclusion of Other Conditions: Other potential causes of neck pain, such as fractures, infections, or tumors, have been ruled out through clinical evaluation or imaging.

4. Functional Impairment: The neck pain is affecting the patient's ability to perform daily activities or work-related tasks.

5. Associated Symptoms: The patient may experience additional symptoms such as stiffness, headaches, or radiating pain to the shoulders or arms.

6. Response to Treatment: The patient has not responded adequately to conservative treatments such as rest, physical therapy, or over-the-counter pain medications.

7. Chronicity: The condition may be classified as chronic if it has lasted for three months or longer, impacting the patient's quality of life.

8. Medical History: The patient has a relevant medical history that may contribute to the cervicalgia, such as previous neck injuries or degenerative disc disease.

For the ICD code M54.2 (Cervicalgia), the relevant CPT codes that may be applicable for treatment include:

1. 99201-99205 - Evaluation and Management (E/M) services for new patients, depending on the complexity and time spent.

2. 99211-99215 - E/M services for established patients, based on the level of service provided.

3. 97110 - Therapeutic exercises to develop strength and endurance, range of motion, and flexibility.

4. 97112 - Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception.

5. 97140 - Manual therapy techniques, such as mobilization/manipulation, manual lymphatic drainage, and manual traction.

6. 97010 - Application of a modality to one or more areas; hot or cold packs.

7. 97035 - Ultrasound therapy.

8. 20552 - Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s).

9. 20610 - Arthrocentesis, aspiration, and/or injection into a major joint or bursa.

10. 98940-98942 - Chiropractic manipulative treatment (CMT); spinal, in one to three regions.

These CPT codes are examples of procedures and services that might be used in the management and treatment of cervicalgia, depending on the specific clinical scenario and treatment plan. Always ensure that the chosen CPT codes accurately reflect the services provided and are supported by the patient's medical record documentation.

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