G55
G55: Nerve root and plexus compressions in diseases classified elsewhere
Billable / specific codeICD-10-CM
G55 is a billable, specific ICD-10-CM code for nerve root and plexus compressions in diseases classified elsewhere. It is valid for submission on a claim.
Check G55 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- nerve root compression (due to) (in) ankylosing spondylitis (M45.-)
- nerve root compression (due to) (in) dorsopathies (M53.-, M54.-)
- nerve root compression (due to) (in) intervertebral disc disorders (M50.1.-, M51.1.-)
- nerve root compression (due to) (in) spondylopathies (M46.-, M48.-)
- nerve root compression (due to) (in) spondylosis (M47.0-, M47.2.-)
Code first
The underlying condition must be sequenced before this code.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
G55 is named in 18 Medicare coverage policies: 18 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- 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
Code history
Unchanged in every release from FY2024 to FY2027.