Diagnosing, Documenting and Coding Sciatica
Sciatica is usually caused by a compressed nerve in the lower spine. The blog discusses the causes, symptoms, treatment options, and ICD-10 codes for sciatica.
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If you have low back pain that radiates through the buttocks down to one leg, it may be a sign of sciatica. Sciatica is a chronic pain condition that occurs due to the compression or irritation of sciatic nerve. Regarded as one of the most common causes of low back and leg pain, sciatica typically affects
people
in
the
30-50
year
age
group.
According
to
a
MedicalNewsToday report, up to 40 percent of people will experience sciatica at least once in their life time, making it challenging to manage. Physician practices treating patients with sciatica need to know the ICD-10 codes to report diagnoses correctly. Outsourcing medical billing services can ensure
complete,
accurate
and
timely
claim
filing
for
appropriate
reimbursement. Causes and Symptoms Sciatica usually affects only one side of the body. The pain may start as a mild ache to a sharp, burning sensation or excruciating pain. It can get worse when you sit, cough or sneeze.. The potential risk factors associated with the condition include - age, obesity, prolonged sitting and diabetes. Although the pain associated with sciatica can be severe, most cases resolve with a combination of non-surgical treatment modalities. However, people who experience severe symptoms like leg weakness or bowel or bladder changes may need to undergo surgery for the same. The nerve condition occurs when the sciatic nerve becomes compressed or irritated usually by a herniated disk in the spine or overgrowth of bone (bone spur) on the vertebrae. Other factors that can cause this condition include piriformis syndrome, trauma, osteoarthritis, stenosis, and spondylolisthesis. In very rare cases, the nerve can be compressed by a tumor or damaged by diabetes.
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Shooting pain that flows from the lower back through the buttock area and into the lower limbs is one of the characteristic symptoms of this condition. Other symptoms include
Weakness, numbness, or difficulty moving the leg or foot
Numbness in the leg along the nerve
Debilitating hip pain
Cramping and weakness in the muscles of the involved leg
Burning or tingling sensation (pins and needles) in the feet and toes
A shooting pain that makes it difficult to stand up
A constant pain on one side of the rear
Sciatic Nerve Disorder -- Diagnosis and Treatment Diagnosis of this nerve condition involves a complete evaluation of patient medical history and a detailed physical and neurological exam to check muscle strength and reflexes. As pain usually becomes worse during activities, the physician may ask the patient to walk on the toes or heels, rise from a squatting position and, while lying on the back, lift their legs one at
a
time.
Imaging
tests
such
as
X-ray,
MRI
scan,
CT
scan
or
Electromyography (EMG) may be done to identify the exact source of pain. Treatment of chronic sciatica usually involves a combination of self-care measures and medical treatment. Generally, most cases of acute sciatica respond well to self-care measures like over-the-counter painkillers (such as ibuprofen, naproxen, or oral steroids), Hot or cold compression packs and gentle exercises (such as walking or light stretching). However, if the pain doesn't improve with self-care measures, neurologists will suggest treatments such as medications (anti-inflammatories, Tricyclic antidepressants, muscle relaxants and anti-seizure medications), physical therapy exercises, steroid injections, spinal decompression therapy and www.outsourcestrategies.com
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chiropractic treatment. Surgery may be recommended when the compressed nerve causes significant weakness, loss of bowel or bladder control, or when the patient experiences pain that progressively worsens or doesn't improve with standard therapies. As part of the surgery, the bone spur or the portion of the herniated disk (that is pressing on the pinched nerve) is removed. Though sciatica is a chronic nerve disorder, timely appropriate treatment and proper rest can improve pain within about six weeks. However, if left untreated, this nerve disorder can lead to serious complications like partial immobility of the leg, loss of feeling sensation in the leg, and other functional disabilities such as limitations in walking, sitting and standing. Activities like frequent twisting, bending and heavy weight lifting that put additional strain and pressure on back area, being overweight and leading a sedentary lifestyle can increase the risks of developing this nerve condition. Maintaining proper posture, exercising regularly, and reducing the hours of sitting can help prevent future sciatica flare-ups. Clinical Documentation and ICD-10 Coding Neurology medical billing and coding involves using the specific ICD-10 diagnosis codes for reporting sciatica on medical claims. Physicians should document the following: 
Presence of lower back pain - lumbago, sciatica, or both -
If sciatica is present, indicate: left side or right side
-
Any type of radiculopathy: indicate if it is associated with an intervertebral disc disorder (i..e., lumbago with sciatica due to intervertebral disc disorder)

All back pain and radiculopathy: indicate distribution by spine region occipto-atlanto-axial,
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cervical,
cervicothoracic,
thoracic,
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thoracolumbar,
lumbar,
lumbosacral,
sacral,
sacrococcygeal,
or
multiple sites in spine
Specify if sciatica is due to: Lesion of the sciatic nerve, or if lumbago is due to low back strain
If the condition is related, include details about the accident (location, activity, etc.)
Indicate any psychogenic dorsalgia
ICD-10 codes for Sciatica
M54.3 - Sciatica
M54.30 - Sciatica, unspecified side
M54.31 - Sciatica, right side
M54.32 - Sciatica, left side
M54.41 Lumbago with sciatica, right side
M54.42 Lumbago with sciatica, left side
M54.5 Low back pain
M51.16 Intervertebral disc disorders w radiculopathy, lumbar region
M51.17 ntervertebral disc disorders w radiculopathy, lumbosacral region
Medical billing and coding for sciatica can be challenging. Outsourcing these tasks to an established medical billing and coding company that offers the services of AAPC-certified coding specialists, can help neurology practices ensure correct and timely medical billing and claims submission.
www.outsourcestrategies.com
918-221-7769