M62.85: Dysfunction of the multifidus muscles, lumbar region
M62.85, dysfunction of the multifidus muscles, lumbar region, is listed as a covered diagnosis in 6 Medicare billing and coding articles that apply to 21 HCPCS Level II codes, including G0299 (Direct skilled nursing services of a registered nurse (rn)…), G0300 (Direct skilled nursing services of a licensed practical…), G0283 (Electrical stimulation (unattended), to one or more areas…). 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 2 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 M62.85 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0299 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0300 | Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| 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 | — | 2 |
| E0783 | Infusion 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 |
| E0786 | Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter) | Special coverage instructions apply | $10,969.75–$11,380.88 (NU) | 1 |
| E0782 | Infusion 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 |
| E0785 | Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement | Special coverage instructions apply | $572.38–$673.39 (KF) | 1 |
| J7999 | Compounded drug, not otherwise classified | Special coverage instructions apply | — | 1 |
| J2278 | Injection, ziconotide, 1 microgram | Special coverage instructions apply | — | 1 |
| J2274 | Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg | Special coverage instructions apply | — | 1 |
| A4220 | Refill kit for implantable infusion pump | Special coverage instructions apply | — | 1 |
| J9200 | Injection, floxuridine, 500 mg | Special coverage instructions apply | — | 1 |
| A9585 | Injection, gadobutrol, 0.1 ml | Carrier judgment | — | 1 |
| Q9953 | Injection, iron-based magnetic resonance contrast agent, per ml | Special coverage instructions apply | — | 1 |
| G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0158 | Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0160 | Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G2169 | Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G0281 | Electrical 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 care | Carrier judgment | — | 1 |
| G0329 | Electromagnetic 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 care | Carrier judgment | — | 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 M62.85
- A56679: Billing and Coding: Hospice The Adult Failure To Thrive Syndrome (Palmetto GBA (HHH MAC); 2 Level II codes). LCD with the same title: L34558
- A56619: Billing and Coding: Nerve Conduction Studies and Electromyography (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B); 9 Level II codes). LCD with the same title: L33461
- A57206: Billing and Coding: Lumbar MRI (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L34220
- A53057: Billing and Coding: Home Health Occupational Therapy (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34560
- A53064: Billing and Coding: Outpatient Occupational Therapy (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34427
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 M62 diagnoses (Other disorders of muscle)
- M62.81 — Muscle weakness (generalized)
- M62.82 — Rhabdomyolysis
- M62.830 — Muscle spasm of back
- M62.831 — Muscle spasm of calf
- M62.838 — Other muscle spasm
- M62.89 — Other specified disorders of muscle
- M62.111 — Other rupture of muscle (nontraumatic), right shoulder
- M62.112 — Other rupture of muscle (nontraumatic), left shoulder
- M62.121 — Other rupture of muscle (nontraumatic), right upper arm
- M62.122 — Other rupture of muscle (nontraumatic), left upper arm
- M62.131 — Other rupture of muscle (nontraumatic), right forearm
- M62.132 — Other rupture of muscle (nontraumatic), left forearm
- M62.141 — Other rupture of muscle (nontraumatic), right hand
- M62.142 — Other rupture of muscle (nontraumatic), left hand
- M62.151 — Other rupture of muscle (nontraumatic), right thigh
- M62.152 — Other rupture of muscle (nontraumatic), left thigh
- M62.161 — Other rupture of muscle (nontraumatic), right lower leg
- M62.162 — Other rupture of muscle (nontraumatic), left lower leg
- M62.171 — Other rupture of muscle (nontraumatic), right ankle and foot
- M62.172 — Other rupture of muscle (nontraumatic), left ankle and foot
- M62.211 — Nontraumatic ischemic infarction of muscle, right shoulder
- M62.212 — Nontraumatic ischemic infarction of muscle, left shoulder
- M62.221 — Nontraumatic ischemic infarction of muscle, right upper arm
- M62.222 — Nontraumatic ischemic infarction of muscle, left upper arm
- M62.231 — Nontraumatic ischemic infarction of muscle, right forearm
- M62.232 — Nontraumatic ischemic infarction of muscle, left forearm
- M62.241 — Nontraumatic ischemic infarction of muscle, right hand
- M62.242 — Nontraumatic ischemic infarction of muscle, left hand
- M62.251 — Nontraumatic ischemic infarction of muscle, right thigh
- M62.252 — Nontraumatic ischemic infarction of muscle, left thigh
Frequently asked questions
Does Medicare cover M62.85 (Dysfunction of the multifidus muscles, lumbar region)?
Medicare covers items and services, not diagnoses. 6 Medicare billing and coding articles list M62.85 as a covered diagnosis for 21 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 M62.85?
The Level II codes from the policies most specific to this diagnosis are G0299 (Direct skilled nursing services of a registered nurse (rn)…, 1 article); G0300 (Direct skilled nursing services of a licensed practical…, 1 article); G0283 (Electrical stimulation (unattended), to one or more areas…, 2 articles); E0783 (Infusion pump system, implantable, programmable (includes…, 1 article); E0786 (Implantable programmable infusion pump, replacement…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with M62.85?
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 M62.85?
A56679 (Billing and Coding: Hospice The Adult Failure To Thrive Syndrome); A56619 (Billing and Coding: Nerve Conduction Studies and Electromyography); A56695 (Billing and Coding: Implantable Infusion Pump), and 3 more articles.
What is ICD-10-CM code M62.85?
M62.85 is the ICD-10-CM code for dysfunction of the multifidus muscles, lumbar region, in category M62 (Other disorders of muscle), chapter 13: Diseases of the musculoskeletal system and connective tissue.
Next steps
- Run a reimbursement report for a device billed under G0299
- Watch G0299 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0299
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