ICD-10-CM · Spine

M51.27

M51.27 identifies disc displacement at the lumbosacral junction — clinically, the L5-S1 level — where the lumbar spine meets the sacrum, with or without associated radiculopathy.

Verified May 8, 2026 · 6 sources ↓

Status: Billable
Chapter: 13
Related CPT: 14
Region: Spine

Drawn from CDCICD10DataAAPCIcdcodesIcd10monitor

Documentation tips

What should appear in the chart to support M51.27.

Source · Editorial brief grounded in 6 cited references ↓

Specify the affected spinal level by name (L5-S1 or 'lumbosacral') in the assessment — 'lumbar disc' alone supports M51.26, not M51.27.
Document the imaging modality and findings: MRI or CT report should confirm disc displacement at L5-S1, including descriptors such as disc protrusion, herniation, or bulge with displacement.
Record neurological examination findings (motor strength, reflexes, straight-leg raise, dermatomal sensory testing) to support or exclude radiculopathy — if radiculopathy is documented, escalate to M51.17.
Note the history of conservative care tried and response (physical therapy, NSAIDs, epidural steroid injections) to establish medical necessity for advanced procedures or surgical referral.
If lumbago or low back pain is the presenting complaint and is directly attributable to the disc displacement, document the causal link explicitly — the Applicable To note allows M51.27 to capture the pain without a secondary M54.5x code.
Flag red-flag symptoms (progressive motor weakness, bowel/bladder dysfunction suggesting cauda equina syndrome) in the note — these change the clinical urgency and may trigger additional codes.

Related CPT procedures

Procedure codes commonly billed with M51.27. Linking the right diagnosis to the right procedure is what establishes medical necessity.

Source · CMS LCDs · AAOS specialty guidance · claims-pattern analysis

22612 $1,467.64

Posterior or posterolateral lumbar arthrodesis of a single interspace, performed via a posterior approach with bone graft and typically pedicle screw fixation to achieve vertebral segment fusion.

22630 $1,510.72

Posterior interbody arthrodesis of a single lumbar interspace, including laminectomy and/or discectomy performed to prepare the interspace for fusion rather than for decompression.

22633 $1,700.11

Single-level lumbar arthrodesis combining posterior or posterolateral technique with posterior interbody technique, including laminectomy and/or discectomy sufficient to prepare the interspace — performed as one surgical session at one lumbar interspace.

22840 $668.35

Posterior non-segmental instrumentation placed during spinal surgery, using rods, hooks, or wires that span multiple vertebral levels without anchoring at each intervening segment.

27279 $758.53

Minimally invasive arthrodesis of the sacroiliac joint using a transfixing implant device placed percutaneously across the joint.

72148 $191.72

Non-contrast MRI of the lumbar spine used to evaluate disc pathology, spinal stenosis, nerve root compression, and other structural abnormalities without administration of contrast material.

72158 $318.31

MRI of the lumbar spinal canal and its contents performed first without contrast, then repeated after contrast administration for enhanced visualization.

97110 $29.06

Therapeutic exercise billed per 15-minute unit, targeting strength, endurance, range of motion, or flexibility with direct one-on-one patient contact.

97016 $12.02

Application of a vasopneumatic (intermittent pneumatic compression) device to one or more extremities to reduce edema or swelling.

99213 $95.19

Established patient office or outpatient visit requiring 20–29 minutes of total time or low-complexity medical decision-making.

99214 $135.61

Office visit for an established patient requiring moderate-complexity medical decision making (MDM), or 30–39 minutes of total provider time on the date of service.

62323 View procedure details

62321 View procedure details

97012 View procedure details

Common coding pitfalls

The recurring mistakes coders make with M51.27 and adjacent codes.

Source · Editorial brief grounded in CDC ICD-10-CM tabular guidance, AAOS coding references, and cited references ↓

Using M51.27 when radiculopathy is documented: if the provider documents nerve root involvement, the correct code is M51.17 (lumbosacral disc displacement with radiculopathy), not M51.27.
Confusing lumbar (M51.26, L1-L4) with lumbosacral (M51.27, L5-S1): the two codes are not interchangeable — assign based on the documented or imaged spinal level.
Adding a redundant M54.5x (low back pain) code when the lumbago is directly attributed to the displacement — M51.27 captures that per the Applicable To note, making the secondary pain code unnecessary and an audit flag.
Coding M51.27 for disc degeneration without displacement — degeneration at the lumbosacral level belongs to M51.37, a distinct subcategory.
Applying M51.27 to a traumatic disc injury sustained in an acute event — acute/traumatic disc injuries code to the S-spine injury range; M51.27 is reserved for non-traumatic displacement.

Clinical context

Source · Editorial summary grounded in 6 cited references ↓

Use M51.27 when imaging (MRI or CT) confirms disc displacement specifically at the lumbosacral region (L5-S1) and the clinical presentation has not been coded to a more specific category. This code sits under the M51.2- 'other displacement' subcategory, meaning it applies when disc displacement is confirmed but the condition does not qualify as one with documented myelopathy (M51.06) or radiculopathy (M51.17). If radiculopathy is present and documented, M51.17 is the correct code — not M51.27.

Do not confuse the lumbosacral region (L5-S1, coded M51.27) with the lumbar region (L1-L4, coded M51.26). The distinction matters for payer adjudication and surgical prior-auth. When displacement is confirmed at both levels, report both codes. The ICD-10-CM Applicable To note for M51.2 includes 'lumbago due to displacement of intervertebral disc,' so low back pain attributable to this displacement does not need a separate M54.5x code.

Excludes notes to respect: cervical and cervicothoracic disc disorders go to M50.-; sacral and sacrococcygeal disorders go to M53.3. Current traumatic injury to the lumbosacral disc is coded from the S-code range (injury of spine by body region), not M51.27. Disc degeneration without displacement at the lumbosacral level is M51.37, a separate parent code with its own subcategory structure.

Sibling codes

Other billable codes under M51.2 (laterality / anatomic variants).

M51.26

Other intervertebral disc displacement, lumbar region

M51.25

Other intervertebral disc displacement, thoracolumbar region

M51.24

Other intervertebral disc displacement, thoracic region

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What is the difference between M51.26 and M51.27?

M51.26 covers disc displacement in the lumbar region (approximately L1-L4), while M51.27 is specific to the lumbosacral region (L5-S1). Assign based on the spinal level documented in the provider note or confirmed on imaging — do not use them interchangeably.

02When does radiculopathy change the code from M51.27?

Any documented radiculopathy at the lumbosacral level upgrades the code to M51.17 (intervertebral disc disorders with radiculopathy, lumbosacral region). M51.27 applies when displacement is confirmed but neurological root involvement is absent or not documented.

03Can I bill a separate low back pain code (M54.5x) alongside M51.27?

No. The ICD-10-CM Applicable To note under M51.2 includes 'lumbago due to displacement of intervertebral disc.' When the back pain is caused by the displacement, M51.27 alone captures it. Adding M54.5x is redundant and can trigger a payer query.

04Does M51.27 require imaging confirmation, or can it be coded on clinical presentation alone?

Strong coding practice and payer medical necessity policies expect imaging confirmation — MRI showing displacement at L5-S1 is the standard. Coding on symptoms alone without imaging leaves the claim vulnerable to denial or audit. Document the imaging result explicitly in the assessment.

05Is M51.27 appropriate for a traumatic disc injury after a fall or accident?

No. Acute traumatic disc injuries are coded from the S-spine injury range (injury of spine by body region). M51.27 is a Chapter 13 musculoskeletal code for non-traumatic displacement. If the displacement is a sequela of a past injury, use the appropriate S-code with 7th character S plus M51.27 as an additional code if clinically appropriate — but confirm with the provider.

06Can M51.27 and M51.37 (lumbosacral disc degeneration) be coded together?

Yes, if both displacement and degeneration are documented and confirmed at the lumbosacral level. They represent distinct pathologies in the ICD-10-CM tabular, and a patient can have both simultaneously. Ensure each is supported by the clinical note and imaging.

07What red-flag symptoms documented in the note should prompt escalation beyond M51.27?

Progressive motor weakness, saddle anesthesia, or loss of bowel/bladder control suggest cauda equina syndrome — a surgical emergency. These findings may require additional diagnosis codes and should trigger immediate specialist referral. The note must reflect the urgency and any additional neurological diagnoses separately from M51.27.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures spinal level (L5-S1 or 'lumbosacral'), imaging confirmation (MRI/CT disc displacement), neurological exam findings (motor grade, reflexes, SLR), and conservative care history from the encounter note. This prevents the most common audit trigger — landing on M51.27 when radiculopathy is documented (correct code: M51.17) — and eliminates the redundant M54.5x back pain code that payers flag when displacement is the documented cause.

See how Mira captures M51.27 documentation