ICD-10-CM · Musculoskeletal & connective tissue
ICD-10-CM · Musculoskeletal & connective tissueM54.06: Panniculitis affecting regions of neck and back, lumbar region
M54.06 is the ICD-10-CM code for Panniculitis affecting regions of neck and back, lumbar region. Billable on U.S. claims with supporting documentation. Chapter: Musculoskeletal & connective tissue. Category: M54.
About this code
Panniculitis affecting regions of neck and back, lumbar region.
M54.06 is an ICD-10-CM diagnosis code for panniculitis affecting regions of neck and back, lumbar region. It sits in the 13. Musculoskeletal & connective tissue chapter of the U.S. clinical modification, under category M54.
This code is billable on U.S. healthcare claims when supported by appropriate clinical documentation. The patient chart must establish the diagnosis, capture any clinical detail encoded in the code (severity, laterality, encounter type, complications where applicable), and demonstrate medical necessity for the billed services.
Payer-specific coverage rules vary. Always cross-check against the current Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs) for the payer adjudicating the claim, plus any specialty-specific CMS Medicare Administrative Contractor guidance.
Billing context
What practitioners watch for on M54.06.
Chapter-level billing guidance for musculoskeletal & connective tissue codes. Code-specific notes ship as the dataset matures.
Documentation
Document anatomic site with laterality (right, left, bilateral), specific joint or bone, encounter type (initial, subsequent, sequela), and any traumatic vs non-traumatic etiology distinction. Pain location and chronicity are coding-required for many M-prefix codes.
Common denial categories
- CO-16: Information missing or incorrect on the claim or in supporting documentation. Add documentation specificity that supports the coded detail; resubmit with corrected information.
- CO-50: Service not deemed medically necessary by the payer. Confirm the diagnosis-procedure relationship matches LCD/NCD coverage, attach clinical justification, appeal with documentation.
- CO-11: Diagnosis is inconsistent with the procedure performed. Verify the diagnosis-to-procedure pairing per payer policy; correct the linked diagnosis pointer or the procedure code.
Coverage signal
Coverage rules vary by payer and by plan. Cross-check against the current Local Coverage Determination (LCD) and National Coverage Determination (NCD) for the adjudicating payer. Medonix runs this check automatically during pre-submission scrubbing.
Common specialties
Orthopedics · Pain Management · Physical Therapy · Chiropractic
Companion CPT codes
Procedures commonly billed alongside M54.06 based on Medonix client production data and CMS coding guidance.
- 99213Office visit, established
- 99214Office visit, established, moderate complexity
- 20610Major joint injection
- 73564X-ray knee, 4+ views
- 97110Therapeutic exercises (PT, 15 min units)
CPT is a registered trademark of the American Medical Association. Codes shown for educational reference only.
Related codes
Other codes in category M54.
- M54.00
Panniculitis affecting regions of neck and back, site unspecified
Open - M54.01
Panniculitis affecting regions of neck and back, occipito-atlanto-axial region
Open - M54.02
Panniculitis affecting regions of neck and back, cervical region
Open - M54.03
Panniculitis affecting regions of neck and back, cervicothoracic region
Open - M54.04
Panniculitis affecting regions of neck and back, thoracic region
Open - M54.05
Panniculitis affecting regions of neck and back, thoracolumbar region
Open - M54.07
Panniculitis affecting regions of neck and back, lumbosacral region
Open - M54.08
Panniculitis affecting regions of neck and back, sacral and sacrococcygeal region
Open
Sources
Where this entry comes from.
- NLM Clinical Tables Search Service: the official U.S. National Library of Medicine API for ICD-10-CM lookup.
- CDC National Center for Health Statistics: annual ICD-10-CM Tabular List release with effective date October 1.
- CMS Medicare Coverage Database: Local Coverage Determinations and National Coverage Determinations for payer-specific rules.
Frequently asked
About ICD-10 code M54.06.
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