M54.6 vs M54.8
M54.6 and M54.8 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on M54.8
dorsalgia in thoracic region (M54.6)
M54.6
Pain in thoracic spine
Billable
- Chapter 13
- Diseases of the musculoskeletal system and connective tissue
- Section
- M50-M54
Indexed under
- Pain › thoracic spine (s)
- Pain › spine › thoracic (s)
M54.8
Other dorsalgia
Not billable
- Chapter 13
- Diseases of the musculoskeletal system and connective tissue
- Section
- M50-M54
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027