Low Back Pain
activeThis value set is used to calculate OP-8 (MRI Lumbar Spine for Low Back Pain), a claims-based measure used in the Centers for Medicare & Medicaid Services' Hospital Outpatient Quality Reporting (HOQR) Program. In calculation of OP-8, diagnoses of biomechanical lesions, dorsopathies, spondylopathies, or dislocations/sprains of the joints and ligaments located in the lumbar spine or pelvis (other other low back pain diagnosis) must appear on the MRI study claim to be eligible for inclusion in the measure's initial patient population.
Purpose(Clinical Focus: This set of values contains ICD-10 codes for low back pain not captured by an alternative diagnostic code.),(Data Element Scope: The intent of this data element is to identify patients with low back pain.),(Inclusion Criteria: ICD-10 codes for low back pain are included in this value set.),(Exclusion Criteria: ICD-10 codes not associated with diagnoses of low back pain are excluded from this value set. Terminologies other than ICD-10 are also excluded from this value set.)
| Code | Display | System |
|---|---|---|
| M43.8X5 | http://hl7.org/fhir/sid/icd-10-cm | |
| M43.8X6 | http://hl7.org/fhir/sid/icd-10-cm | |
| M43.8X7 | http://hl7.org/fhir/sid/icd-10-cm | |
| M43.8X8 | http://hl7.org/fhir/sid/icd-10-cm | |
| M43.8X9 | http://hl7.org/fhir/sid/icd-10-cm | |
| M43.9 | http://hl7.org/fhir/sid/icd-10-cm | |
| M46.46 | http://hl7.org/fhir/sid/icd-10-cm | |
| M46.47 | http://hl7.org/fhir/sid/icd-10-cm | |
| M47.20 | http://hl7.org/fhir/sid/icd-10-cm | |
| M47.26 | http://hl7.org/fhir/sid/icd-10-cm | |
| M47.27 | http://hl7.org/fhir/sid/icd-10-cm | |
| M47.28 | http://hl7.org/fhir/sid/icd-10-cm | |
| M47.816 | http://hl7.org/fhir/sid/icd-10-cm | |
| M47.817 | http://hl7.org/fhir/sid/icd-10-cm | |
| M47.818 | http://hl7.org/fhir/sid/icd-10-cm | |
| M47.819 | http://hl7.org/fhir/sid/icd-10-cm | |
| M47.896 | http://hl7.org/fhir/sid/icd-10-cm | |
| M47.897 | http://hl7.org/fhir/sid/icd-10-cm | |
| M47.898 | http://hl7.org/fhir/sid/icd-10-cm | |
| M47.899 | http://hl7.org/fhir/sid/icd-10-cm |
{
"description" : "This value set is used to calculate OP-8 (MRI Lumbar Spine for Low Back Pain), a claims-based measure used in the Centers for Medicare & Medicaid Services' Hospital Outpatient Quality Reporting (HOQR) Program. In calculation of OP-8, diagnoses of biomechanical lesions, dorsopathies, spondylopathies, or dislocations/sprains of the joints and ligaments located in the lumbar spine or pelvis (other other low back pain diagnosis) must appear on the MRI study claim to be eligible for inclusion in the measure's initial patient population.",
"compose" : {
"exclude" : [ ],
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},
"date" : "2018-06-15T01:00:04-04:00",
"meta" : {
"versionId" : "5",
"lastUpdated" : "2023-12-21T17:43:03.000-05:00",
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"publisher" : "Lewin EH Steward",
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"purpose" : "(Clinical Focus: This set of values contains ICD-10 codes for low back pain not captured by an alternative diagnostic code.),(Data Element Scope: The intent of this data element is to identify patients with low back pain.),(Inclusion Criteria: ICD-10 codes for low back pain are included in this value set.),(Exclusion Criteria: ICD-10 codes not associated with diagnoses of low back pain are excluded from this value set. Terminologies other than ICD-10 are also excluded from this value set.)",
"name" : "LowBackPain",
"experimental" : false,
"resourceType" : "ValueSet",
"expansion" : {
"contains" : [ {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M43.5X5",
"display" : "Other recurrent vertebral dislocation, thoracolumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M43.5X6",
"display" : "Other recurrent vertebral dislocation, lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M43.5X7",
"display" : "Other recurrent vertebral dislocation, lumbosacral region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M43.5X8",
"display" : "Other recurrent vertebral dislocation, sacral and sacrococcygeal region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M43.5X9",
"display" : "Other recurrent vertebral dislocation, site unspecified",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M43.8X5",
"display" : "Other specified deforming dorsopathies, thoracolumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M43.8X6",
"display" : "Other specified deforming dorsopathies, lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M43.8X7",
"display" : "Other specified deforming dorsopathies, lumbosacral region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M43.8X8",
"display" : "Other specified deforming dorsopathies, sacral and sacrococcygeal region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M43.8X9",
"display" : "Other specified deforming dorsopathies, site unspecified",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M43.9",
"display" : "Deforming dorsopathy, unspecified",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M46.46",
"display" : "Discitis, unspecified, lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M46.47",
"display" : "Discitis, unspecified, lumbosacral region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M47.20",
"display" : "Other spondylosis with radiculopathy, site unspecified",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M47.26",
"display" : "Other spondylosis with radiculopathy, lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M47.27",
"display" : "Other spondylosis with radiculopathy, lumbosacral region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M47.28",
"display" : "Other spondylosis with radiculopathy, sacral and sacrococcygeal region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M47.816",
"display" : "Spondylosis without myelopathy or radiculopathy, lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M47.817",
"display" : "Spondylosis without myelopathy or radiculopathy, lumbosacral region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M47.818",
"display" : "Spondylosis without myelopathy or radiculopathy, sacral and sacrococcygeal region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M47.819",
"display" : "Spondylosis without myelopathy or radiculopathy, site unspecified",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M47.896",
"display" : "Other spondylosis, lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M47.897",
"display" : "Other spondylosis, lumbosacral region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M47.898",
"display" : "Other spondylosis, sacral and sacrococcygeal region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M47.899",
"display" : "Other spondylosis, site unspecified",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M47.9",
"display" : "Spondylosis, unspecified",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M48.06",
"display" : "Spinal stenosis, lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M48.061",
"display" : "Spinal stenosis, lumbar region without neurogenic claudication",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M48.062",
"display" : "Spinal stenosis, lumbar region with neurogenic claudication",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M48.07",
"display" : "Spinal stenosis, lumbosacral region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M51.26",
"display" : "Other intervertebral disc displacement, lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M51.27",
"display" : "Other intervertebral disc displacement, lumbosacral region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M51.34",
"display" : "Other intervertebral disc degeneration, thoracic region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M51.35",
"display" : "Other intervertebral disc degeneration, thoracolumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M51.36",
"display" : "Other intervertebral disc degeneration, lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M51.37",
"display" : "Other intervertebral disc degeneration, lumbosacral region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M51.86",
"display" : "Other intervertebral disc disorders, lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M51.87",
"display" : "Other intervertebral disc disorders, lumbosacral region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M53.86",
"display" : "Other specified dorsopathies, lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M53.87",
"display" : "Other specified dorsopathies, lumbosacral region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M53.88",
"display" : "Other specified dorsopathies, sacral and sacrococcygeal region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M54.30",
"display" : "Sciatica, unspecified side",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M54.31",
"display" : "Sciatica, right side",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M54.32",
"display" : "Sciatica, left side",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M54.40",
"display" : "Lumbago with sciatica, unspecified side",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M54.41",
"display" : "Lumbago with sciatica, right side",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M54.42",
"display" : "Lumbago with sciatica, left side",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M54.5",
"display" : "Low back pain",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M54.89",
"display" : "Other dorsalgia",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M54.9",
"display" : "Dorsalgia, unspecified",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M99.03",
"display" : "Segmental and somatic dysfunction of lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M99.04",
"display" : "Segmental and somatic dysfunction of sacral region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M99.23",
"display" : "Subluxation stenosis of neural canal of lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M99.33",
"display" : "Osseous stenosis of neural canal of lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M99.43",
"display" : "Connective tissue stenosis of neural canal of lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M99.53",
"display" : "Intervertebral disc stenosis of neural canal of lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M99.63",
"display" : "Osseous and subluxation stenosis of intervertebral foramina of lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M99.73",
"display" : "Connective tissue and disc stenosis of intervertebral foramina of lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M99.83",
"display" : "Other biomechanical lesions of lumbar region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "M99.84",
"display" : "Other biomechanical lesions of sacral region",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "S33.5XXA",
"display" : "Sprain of ligaments of lumbar spine, initial encounter",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "S33.5XXD",
"display" : "Sprain of ligaments of lumbar spine, subsequent encounter",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "S33.5XXS",
"display" : "Sprain of ligaments of lumbar spine, sequela",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "S33.6XXA",
"display" : "Sprain of sacroiliac joint, initial encounter",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "S33.6XXD",
"display" : "Sprain of sacroiliac joint, subsequent encounter",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "S33.6XXS",
"display" : "Sprain of sacroiliac joint, sequela",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "S33.8XXA",
"display" : "Sprain of other parts of lumbar spine and pelvis, initial encounter",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "S33.8XXD",
"display" : "Sprain of other parts of lumbar spine and pelvis, subsequent encounter",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "S33.8XXS",
"display" : "Sprain of other parts of lumbar spine and pelvis, sequela",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "S33.9XXA",
"display" : "Sprain of unspecified parts of lumbar spine and pelvis, initial encounter",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "S33.9XXD",
"display" : "Sprain of unspecified parts of lumbar spine and pelvis, subsequent encounter",
"version" : "2024"
}, {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "S33.9XXS",
"display" : "Sprain of unspecified parts of lumbar spine and pelvis, sequela",
"version" : "2024"
} ],
"total" : 72,
"identifier" : "urn:uuid:06b4dca1-53a7-4c8b-9f0c-29c5777fe60c",
"timestamp" : "2024-04-23T17:43:25-04:00"
},
"title" : "Low Back Pain",
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}| Title | Version | Status | Publisher | Date |
|---|---|---|---|---|
| Low Back Pain | 20180615 | retired | Lewin EH Steward | - |
| Low Back Pain | 20180615 | active | Lewin EH Steward | - |