G54
G54 — Nerve root and plexus disorders
Non-billable headerICD-10-CM
G54 is a non-billable header ICD-10-CM code for nerve root and plexus disorders. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- current traumatic nerve root and plexus disorders - see nerve injury by body region
- intervertebral disc disorders (M50-M51)
- neuralgia or neuritis NOS (M79.2)
- neuritis or radiculitis brachial NOS (M54.13)
- neuritis or radiculitis lumbar NOS (M54.16)
- neuritis or radiculitis lumbosacral NOS (M54.17)
- neuritis or radiculitis thoracic NOS (M54.14)
- radiculitis NOS (M54.10)
- radiculopathy NOS (M54.10)
- spondylosis (M47.-)
Other codes that can never be billed with G54
These codes carry an Excludes1 note pointing at G54. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading G54 alone.
- M62.5Muscle wasting and atrophy, not elsewhere classified
Risk adjustment
G54 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead G54
10 child codes. Green means billable.
- G54.0Brachial plexus disorders
- G54.1Lumbosacral plexus disorders
- G54.2Cervical root disorders, not elsewhere classified
- G54.3Thoracic root disorders, not elsewhere classified
- G54.4Lumbosacral root disorders, not elsewhere classified
- G54.5Neuralgic amyotrophy
- G54.6Phantom limb syndrome with pain
- G54.7Phantom limb syndrome without pain
- G54.8Other nerve root and plexus disorders
- G54.9Nerve root and plexus disorder, unspecified
Questions about G54
- Is G54 a billable ICD-10-CM code?
- No. G54 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does G54 sit in the tabular list?
- Diseases of the nervous system (G00-G99), in the block Nerve, nerve root and plexus disorders (G50-G59).
- What cannot be coded together with G54?
- G54 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.