Low Back Pain and Spinal Stenosis: Why These Diagnoses Are Common for Patients with Fidelis Insurance
Low back pain is one of the most common reasons people seek medical care, and it is a diagnosis Dr. George Kakoulides sees daily at his Long Island neurosurgery practice. For patients with Fidelis Care insurance and many other insurance carriers, two spine-related diagnoses appear frequently: low back pain, unspecified (M54.50) and lumbar spinal stenosis (M48.062).
In this article, Dr. Kakoulides explains what these conditions mean, why they are often diagnosed, and how his team works closely with Fidelis Care members to provide advanced, patient-centered treatment.
Low Back Pain, Unspecified (M54.50)
Low back pain is not just a single condition. It’s a symptom with many potential causes, including muscle strain, disc degeneration, arthritis, or nerve irritation. When a patient first presents with back pain, the initial diagnosis may be coded as “low back pain, unspecified” if more detailed imaging or testing has not yet pinpointed the exact source.
This diagnosis is extremely common because:
- It is often the starting point before more specific findings are identified.
- It applies to a wide range of patients, from young adults to seniors.
- Medicaid and Medicare Advantage plans, like Fidelis Care, frequently document it for insurance and referral purposes.
Lumbar Spinal Stenosis (M48.062)
Spinal stenosis occurs when the space within the spine narrows, putting pressure on the nerves. In the lumbar (lower back) region, this can cause symptoms such as:
- Pain or heaviness in the legs while walking
- Numbness, tingling, or weakness
- Relief when sitting or bending forward
For many patients, lumbar spinal stenosis is a common diagnosis because it is strongly associated with age-related changes in the spine. Fidelis insures a large number of older adults and individuals with chronic conditions, making this diagnosis more prevalent.
Why These Diagnoses Are Common Among Fidelis Care Patients
Several factors contribute to why low back pain unspecified and lumbar spinal stenosis are seen so often in Fidelis Care patients:
- Demographics: Fidelis serves many older adults, who are at higher risk for degenerative spine conditions.
- Access to care: Patients often see primary care providers or urgent care first, where “unspecified” diagnoses are initially assigned until a specialist evaluation is completed.
- Chronic conditions: Obesity, sedentary lifestyles, and osteoarthritis—can accelerate spine degeneration.
Dr. Kakoulides’ Approach to Treating Fidelis Care Patients
Dr. George Kakoulides treats many patients at his neurosurgery practice. His approach focuses on:
- Accurate diagnosis: Using advanced imaging to move from “unspecified” to specific causes of pain.
- Comprehensive treatment: Combining non-surgical treatments (physical therapy, injections, medications) with surgical options when necessary.
- Patient-centered care: Helping Fidelis Care members navigate insurance authorizations and access the care they need without unnecessary delays.
If you are experiencing low back pain or symptoms of spinal stenosis, you are not alone—and there are effective treatments available. Dr. Kakoulides and his team have extensive experience treating Fidelis patients, helping them regain mobility, reduce pain, and improve their quality of life.
