M54.10: Radiculopathy, site unspecified
M54.10, radiculopathy, site unspecified, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 8 HCPCS Level II codes, including G0480 (Drug test(s), definitive, utilizing (1) drug…), G0483 (Drug test(s), definitive, utilizing (1) drug…), G0482 (Drug test(s), definitive, utilizing (1) drug…). The articles come from 4 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with M54.10 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed | Carrier judgment | — | 2 |
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed | Carrier judgment | — | 2 |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed | Carrier judgment | — | 2 |
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed | Carrier judgment | — | 2 |
| G0659 | Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem), excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes | Carrier judgment | — | 2 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0282 | Electrical stimulation, (unattended), to one or more areas, for wound care other than described in g0281 | Non-covered by Medicare | Not covered | 1 |
| G0255 | Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve | Non-covered by Medicare | Not covered | 1 |
Medicare policy articles listing M54.10
- A57077: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L35006, L36393
- A56034: Billing and Coding: Nerve Blockade for Treatment of Chronic Pain and Neuropathy (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L35456
- A56645: Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L35006, L36393
- A57668: Billing and Coding: Nerve Conduction Studies and Electromyography (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other M54 diagnoses (Dorsalgia)
- M54.11 — Radiculopathy, occipito-atlanto-axial region
- M54.12 — Radiculopathy, cervical region
- M54.13 — Radiculopathy, cervicothoracic region
- M54.14 — Radiculopathy, thoracic region
- M54.15 — Radiculopathy, thoracolumbar region
- M54.16 — Radiculopathy, lumbar region
- M54.17 — Radiculopathy, lumbosacral region
- M54.18 — Radiculopathy, sacral and sacrococcygeal region
- M54.03 — Panniculitis affecting regions of neck and back, cervicothoracic…
- M54.04 — Panniculitis affecting regions of neck and back, thoracic region
- M54.05 — Panniculitis affecting regions of neck and back, thoracolumbar region
- M54.06 — Panniculitis affecting regions of neck and back, lumbar region
- M54.07 — Panniculitis affecting regions of neck and back, lumbosacral region
- M54.08 — Panniculitis affecting regions of neck and back, sacral and…
- M54.09 — Panniculitis affecting regions, neck and back, multiple sites in spine
- M54.2 — Cervicalgia
- M54.31 — Sciatica, right side
- M54.32 — Sciatica, left side
- M54.41 — Lumbago with sciatica, right side
- M54.42 — Lumbago with sciatica, left side
- M54.50 — Low back pain, unspecified
- M54.51 — Vertebrogenic low back pain
- M54.59 — Other low back pain
- M54.6 — Pain in thoracic spine
- M54.89 — Other dorsalgia
- M54.9 — Dorsalgia, unspecified
Frequently asked questions
Does Medicare cover M54.10 (Radiculopathy, site unspecified)?
Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list M54.10 as a covered diagnosis for 8 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 M54.10?
The Level II codes from the policies most specific to this diagnosis are G0480 (Drug test(s), definitive, utilizing (1) drug…, 2 articles); G0483 (Drug test(s), definitive, utilizing (1) drug…, 2 articles); G0482 (Drug test(s), definitive, utilizing (1) drug…, 2 articles); G0481 (Drug test(s), definitive, utilizing (1) drug…, 2 articles); G0659 (Drug test(s), definitive, utilizing drug identification…, 2 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list M54.10?
A57077 (Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing); A56034 (Billing and Coding: Nerve Blockade for Treatment of Chronic Pain and Neuropathy); A56645 (Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing), and 1 more article.
What is ICD-10-CM code M54.10?
M54.10 is the ICD-10-CM code for radiculopathy, site unspecified, in category M54 (Dorsalgia), chapter 13: Diseases of the musculoskeletal system and connective tissue.
Next steps
- Run a reimbursement report for a device billed under G0480
- Watch G0480 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0480
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 13: Diseases of the musculoskeletal system and connective tissue · All diagnoses · HCPCS lookup