ICD-10 Code M54.5 Retired as of Oct 1
Some examples of more specific codes are:
S39.012: Low back strain
M51.2-: Lumbago due to intervertebral disc displacement
M54.4-: Lumbago with sciatica
M54.50: Low back pain,unspecified
M54.51: Vertebrogenic low back pain
If updating a diagnosis code within a plan of care, it's always a good idea to make the physician aware as well as your authorization team if the patient's plan requires authorization.
Effective Oct 1 Triwest Requires Referral Number on Claims
Submit claims with the following:
VA referral/authorization number AND one of the following:
10-digit Electronic Data Interchange Personal Identifier (EDIPI)
17-digit Master Veteran Index (MVI) ICN
Social Security number (SSN)
Last 4 digits for SSN with preceding 5 zeros (i.e., 00000XXXX)
Federal Employee BCBS Plan Issue
If you are receiving inaccurate denials for "duplicates", please know the APTA is actively working on this and will soon relay more information on how to resubmit these claims for accurate payment.