CMS' move to establish the new ICD-10 code — M62.85: Dysfunction of the Multifidus Muscles, Lumbar Region — is part of ongoing efforts by spine surgeons who want more coding clarifications for back pain.
The code went into effect Oct. 1.
"This update brings essential specificity to diagnosing patients with chronic mechanical low back pain, a condition that has long frustrated patients and clinicians alike," the International Society for the Advancement of Spine Surgery's Co-President Morgan Lorio, MD, told Becker's in a statement. "For those who have exhausted conservative treatments and are not surgical candidates, this code represents a meaningful advancement, opening new pathways for appropriate and effective treatment."
Chronic lower back pain has historically been challenging to manage since it often lacks structural indicators, but recent developments into multifidus dysfunction bring new understanding to the pain, Dr. Lorio said.
The organization collaborated with Mainstay Medical, which develops the ReActiv8 neurostimulation device, to advocate for the coding update. ISASS reviewed evidence of ReActiv8 and published a statement in the International Journal of Spine Surgery last year — "Restorative Neurostimulation for Chronic Mechanical Low Back Pain Resulting From Neuromuscular Instability."
"We are proud of the compendium of evidence that has been built to demonstrate the long-term benefits of the ReActiv8 therapy," Mainstay Medical CEO Jason Hannon said in a statement. "We are confident that this new diagnostic code will help national payors to support the use of this therapy with their patients."
Dr. Lorio said he's excited about what the new ICD-10 code means for spine care.
"This new code represents a significant step toward establishing restorative neurostimulation as a standard of care for patients with CLBP, enabling clinicians to more accurately diagnose and treat this population," Dr. Lorio said. "Additionally, it will facilitate national payors in covering treatments that rely on this more precise diagnostic framework."