G54.7 — Phantom limb syndrome without pain
G54.7 is a billable, specific ICD-10-CM code for phantom limb syndrome without pain. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Phantom limb syndrome NOS
Risk adjustment
G54.7 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 409 Amputation Status, Lower Limb/Amputation Complications0.598 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
G54.7 is named in 13 Medicare coverage policies — 13 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53058Billing and Coding: Home Health Physical Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
How G54.7 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to G54.7.
- Phantom limb syndrome(without pain)
- Syndrome›phantom limb(without pain)
Related codes at this level
Codes that share G54. If G54.7 is not quite right, the correct code is usually one of these.
- 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
- G54.8Other nerve root and plexus disorders
- G54.9Nerve root and plexus disorder, unspecified
Questions about G54.7
- Is G54.7 a billable ICD-10-CM code?
- Yes. G54.7 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does G54.7 sit in the tabular list?
- Diseases of the nervous system (G00-G99), in the block Nerve, nerve root and plexus disorders (G50-G59).