Is G55 a billable ICD-10-CM code?

Yes. G55 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does G55 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 G55?

G55 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

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.

Excludes1 — 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.

underlying disease, such as:
neoplasm (C00-D49)

Risk adjustment

G55 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.

Medicare coverage

G55 is named in 18 Medicare coverage policies — 18 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

Questions about G55

Is G55 a billable ICD-10-CM code?: Yes. G55 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does G55 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 G55?: G55 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.