M54.2: Cervicalgia

M54.2, cervicalgia, is listed as a covered diagnosis in 25 Medicare billing and coding articles that apply to 35 HCPCS Level II codes, including J0585 (Injection, onabotulinumtoxina, 1 unit), J0588 (Injection, incobotulinumtoxin a, 1 unit), J0586 (Injection, abobotulinumtoxina, 5 units). 4 of these codes have a 2026 DMEPOS fee schedule amount; E0783 pays $9,917.33 to $11,667.45 (NU) depending on the state. The articles come from 7 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 M54.2 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J0585Injection, onabotulinumtoxina, 1 unitSpecial coverage instructions apply—6
J0588Injection, incobotulinumtoxin a, 1 unitCarrier judgment—6
J0586Injection, abobotulinumtoxina, 5 unitsCarrier judgment—6
J0587Injection, rimabotulinumtoxinb, 100 unitsSpecial coverage instructions apply—6
J0589Injection, daxibotulinumtoxina-lanm, 1 unitCarrier judgment—6
G0480Drug 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 performedCarrier judgment—7
G0483Drug 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 performedCarrier judgment—7
G0482Drug 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 performedCarrier judgment—7
G0481Drug 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 performedCarrier judgment—7
G0659Drug 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 classesCarrier judgment—7
Q2028Injection, sculptra, 0.5 mgSpecial coverage instructions apply—2
G0429Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)Carrier judgment—2
Q2026Injection, radiesse, 0.1 mlSpecial coverage instructions apply—2
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of careCarrier judgment—4
E0783Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)Special coverage instructions apply$9,917.33–$11,667.45 (NU)1
E0786Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)Special coverage instructions apply$10,969.75–$11,380.88 (NU)1
E0782Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)Special coverage instructions apply$5,200.92–$6,118.73 (NU)1
E0785Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacementSpecial coverage instructions apply$572.38–$673.39 (KF)1
J7999Compounded drug, not otherwise classifiedSpecial coverage instructions apply—1
J2278Injection, ziconotide, 1 microgramSpecial coverage instructions apply—1
J2274Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mgSpecial coverage instructions apply—1
A4220Refill kit for implantable infusion pumpSpecial coverage instructions apply—1
J9200Injection, floxuridine, 500 mgSpecial coverage instructions apply—1
G0281Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of careCarrier judgment—2
G0329Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of careCarrier judgment—2

10 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing M54.2

10 more articles list M54.2.

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)

Frequently asked questions

Does Medicare cover M54.2 (Cervicalgia)?

Medicare covers items and services, not diagnoses. 25 Medicare billing and coding articles list M54.2 as a covered diagnosis for 35 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 M54.2?

The Level II codes from the policies most specific to this diagnosis are J0585 (Injection, onabotulinumtoxina, 1 unit, 6 articles); J0588 (Injection, incobotulinumtoxin a, 1 unit, 6 articles); J0586 (Injection, abobotulinumtoxina, 5 units, 6 articles); J0587 (Injection, rimabotulinumtoxinb, 100 units, 6 articles); J0589 (Injection, daxibotulinumtoxina-lanm, 1 unit, 6 articles). Code choice depends on the item supplied; check each code's descriptor.

What does Medicare pay for equipment billed with M54.2?

Under the 2026 DMEPOS fee schedule (non-rural state fees): E0783 $9,917.33 to $11,667.45 (NU); E0786 $10,969.75 to $11,380.88 (NU); E0782 $5,200.92 to $6,118.73 (NU); E0785 $572.38 to $673.39 (KF). Medicare pays 80% of the allowed amount after the Part B deductible.

Which Medicare policy articles list M54.2?

A59299 (Billing and Coding: Cosmetic and Reconstructive Surgery); A58774 (Billing and Coding: Cosmetic and Reconstructive Surgery); A57185 (Billing and Coding: Botulinum Toxin Injections), and 22 more articles.

What is ICD-10-CM code M54.2?

M54.2 is the ICD-10-CM code for cervicalgia, in category M54 (Dorsalgia), chapter 13: Diseases of the musculoskeletal system and connective tissue.

Next steps

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