Neck pain is one of the most frequently reported symptoms across clinical specialties. From chiropractic offices to urgent care clinics and orthopedic practices, providers encounter this diagnosis daily. That means selecting the correct neck pain ICD-10 codes is not just about compliance—it directly impacts billing accuracy and claim approval.
This guide covers the ICD-10 code for neck pain, when to use the most common ICD-10 code for neck pain, what modifiers apply, whether it is a billable diagnosis, and how to avoid common documentation issues.
Whether you’re a medical coder, biller, practice manager, or provider, this post is designed to help you code neck pain clearly, cleanly, and compliantly.
What Is the ICD-10 Code for Neck Pain?
The most direct and frequently used ICD-10 code for neck pain is M54.2 — Cervicalgia. This code applies when the patient presents with localized neck pain not linked to a specific condition like disc herniation, trauma, or neurological symptoms.
M54.2 is:
• A billable code
• Used for general or nonspecific neck pain
• Accepted by most payers without the need for a secondary diagnosis
Is Neck Pain a Billable ICD-10 Diagnosis?
Yes. Neck pain is a billable ICD-10 diagnosis, provided it is supported by adequate documentation. M54.2 is a valid primary code in most scenarios where the cause of pain is unclear or not linked to structural damage.
To ensure it is billable, documentation should clearly state:
• Onset (sudden or gradual)
• Location (right side, left side, midline)
• Severity and duration
• Whether the pain radiates
• Associated symptoms like numbness or tingling
• Any identifiable cause, such as posture, trauma, or strain
If documentation lacks these elements, the claim is more likely to be denied or flagged for audit.
Related ICD-10 Codes for Neck Pain
M54.2 is not always the correct code. When neck pain is tied to specific causes or presents with complex symptoms, more precise coding is necessary.
Here are related codes coders often use instead of or alongside M54.2:
• M54.12 – Cervical radiculopathy (neck pain with nerve root involvement)
• M50.10 – Cervical disc disorder without radiculopathy
• M62.830 – Muscle spasm of the back (when pain is muscular)
• G54.2 – Cervical root disorders
• S16.1XXA – Strain of muscle, fascia, or tendon at neck level (initial encounter)
• T14.8XXA – Injury of unspecified body region (used only when details are lacking)
Always use the most specific code available based on provider documentation.
Most Common ICD-10 Code for Neck Pain
The most common ICD-10 code for neck pain in outpatient settings is M54.2. It is widely used in:
• Primary care
• Physical therapy
• Chiropractic care
• Occupational health clinics
• Urgent care and emergency departments
Though it’s commonly used, it’s not always the most appropriate. Over-reliance on M54.2 without clinical justification can lead to claim denials or compliance issues during audits.
What Modifiers Are Used With Neck Pain ICD-10 Codes?
Modifiers don’t apply directly to ICD codes—they’re used with CPT codes—but they help support the diagnostic connection when billing services for neck pain. When ICD 10 codes for neck pain are billed alongside procedures or therapy, these modifiers help clarify the context.
Common modifiers include:
• 25 – Significant and separately identifiable E/M service on the same day
• 59 – Distinct procedural service, often used with therapy or injections
• GP – Indicates services delivered under a physical therapy plan
• AT – Active treatment for chiropractic spinal manipulation
• RT/LT – Specifies right or left side when laterality is involved
Using the right modifiers improves claim accuracy and reduces rejections for bundling or duplication.
Documentation Tips for Neck Pain Coding
To justify neck pain ICD 10 codes—especially M54.2 or condition-specific ones like M54.12—your documentation must tell the complete clinical story.
Ensure the record includes:
• Pain location and whether it radiates
• Onset and duration (acute vs. chronic)
• Cause if known (posture, injury, lifting, work task)
• Neurological findings or motor weakness
• Imaging results, if available
• Functional impact (e.g., unable to turn head, sleep, work)
Poor documentation is a leading cause of denied claims in musculoskeletal coding. Aim for clarity, specificity, and objective findings.
Common Coding Scenarios and How to Code Them
Here are a few real-world coding examples using neck pain ICD-10 codes:
• Case 1 – Simple neck pain from poor posture
Diagnosis: M54.2
Modifiers: None needed unless therapy is performed
• Case 2 – Neck pain with arm tingling and disc bulge on MRI
Diagnosis: M54.12 (radiculopathy) + M50.10 (disc disorder)
Modifiers: GP or AT, depending on service type
• Case 3 – Neck strain after lifting at work
Diagnosis: S16.1XXA
Modifiers: Add work-related external cause codes if payer requires
• Case 4 – Neck spasm during stress episode
Diagnosis: M62.830
Modifiers: None unless service is therapeutic
• Case 5 – Chronic neck pain managed with chiropractic care
Diagnosis: M54.2
Modifiers: AT + 25 if E/M performed alongside adjustment
Industry Insight: Why Neck Pain Coding Matters
Recent data shows that neck pain affects over 30% of adults at least once per year, and it’s the fourth leading cause of disability globally. That makes it a significant driver of healthcare utilization.
Industry trends worth noting:
• Many practices under-code or overuse M54.2 without documenting radicular signs
• Physical therapy and chiropractic billing often misses proper modifier use
• Payers have increased claim scrutiny for recurring neck pain codes without updated notes
• Coders often omit secondary codes that explain cause, such as strain or disc degeneration
Being precise and proactive with neck pain coding improves revenue integrity and reduces claim rework.
Final Thoughts
Coding for neck pain is more than selecting M54.2. It requires awareness of the full diagnostic picture, current documentation, appropriate modifiers, and the ability to spot red flags.
Neck pain ICD-10 codes like M54.2, M54.12, and M50.10 are powerful tools when used accurately and responsibly. Coders and billers must collaborate with providers to ensure clean claims, prevent denials, and stay compliant with payer policy.
A well-documented note. a well-chosen code. and the right modifier—this is the formula for successful neck pain coding in 2025 and beyond.
