What is ICD-10 code G50.0?

G50.0 is the ICD-10-CM diagnosis code for Trigeminal neuralgia. Severe facial pain caused by irritation of the trigeminal nerve, typically affecting one side of the face with sudden, sharp, shooting pain. It belongs to the ICD-10-CM chapter for diseases of the nervous system (g00-g99). G50.0 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. G50.0 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. G50.0 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. G50.0 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for G50.0?

G50.0 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither community model rewards G50.0 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. It does, however, map under the Part D RxHCC model (Trigeminal and Postherpetic Neuralgia), which affects the ESRD and/or Part D (RxHCC) risk scores. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

What should coders know when reporting G50.0?

Specify laterality (right, left, or bilateral) when coding trigeminal neuralgia for complete documentation Document whether the condition is idiopathic or secondary to another condition

2026 ICD-10-CM G50.0: Trigeminal neuralgia

ICD-10-CM Code View

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Code lookupG50.0Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Nerve, nerve root and plexus disorders (G50-G59)

G50.0

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Trigeminal neuralgia

Severe facial pain caused by irritation of the trigeminal nerve, typically affecting one side of the face with sudden, sharp, shooting pain.

Buddy Insight

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

Mapped

HCC 168

Trigeminal and Postherpetic N...

RAF 0.094

Code Book Path

Official

G50Disorders of trigeminal nerve

G50.0Trigeminal neuralgia

Inclusion Terms

Official

Syndrome of paroxysmal facial pain
Tic douloureux

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for G50.0 in this effective period.

Related Child Codes

Official

G50.1Atypical facial pain

G50.8Other disorders of trigeminal nerve

G50.9Disorder of trigeminal nerve, unspecified

Includes

Official

disorders of 5th cranial nerve

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for G50.0 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for G50.0 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for G50.0 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for G50.0 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Paroxysmal attacks of facial pain lasting fractions of a second to 2 minutes

Pain distribution following trigeminal nerve branches (V1 ophthalmic, V2 maxillary, V3 mandibular)

Pain characteristics: intense, sharp, superficial, stabbing, or electric shock-like

Trigger zones or triggering activities identified (chewing, talking, light touch, brushing teeth)

MEAT Support

HCC Buddy guidance

Paroxysmal attacks of facial pain lasting fractions of a second to 2 minutes

Pain distribution following trigeminal nerve branches (V1 ophthalmic, V2 maxillary, V3 mandibular)

Pain characteristics: intense, sharp, superficial, stabbing, or electric shock-like

Trigger zones or triggering activities identified (chewing, talking, light touch, brushing teeth)

Audit Caution

HCC Buddy guidance

Confusing trigeminal neuralgia with dental pain — many patients undergo unnecessary dental procedures before correct diagnosis

Not specifying G50.0 when trigeminal neuralgia is documented, defaulting to unspecified G50.9

Coding atypical facial pain (G50.1) when the presentation meets classic trigeminal neuralgia criteria

Failing to capture the underlying cause when secondary trigeminal neuralgia is present (e.g., MS should be coded additionally)

Common Mistakes

HCC Buddy guidance

G50.1 (Atypical facial pain) — continuous, poorly localized facial pain without the paroxysmal shock-like quality of trigeminal neuralgia

G50.8 (Other disorders of trigeminal nerve) — specific but not neuralgia; includes trigeminal neuropathy without pain paroxysms

G50.9 (Disorder of trigeminal nerve, unspecified) — less specific; always code to G50.0 when trigeminal neuralgia is diagnosed

G44.89 (Other headache syndrome) — headache disorders; trigeminal neuralgia is facial pain, not headache

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is G50.0 an HCC code?

G50.0 is not in the CMS-HCC V28 or V24 community payment model, but it does map to Trigeminal and Postherpetic Neuralgia under the Part D RxHCC model.

Code: G50.0
Description: Trigeminal neuralgia
HCC (V28): No CMS-HCC V28 mapping
RAF: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

RxHCCHCC 168, Trigeminal and Postherpetic Neuralgia

0.094

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work G50.0 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for G50.0

For G50.0 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed G50.0 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

G50.0 is the ICD-10-CM diagnosis code for trigeminal neuralgia. Severe facial pain caused by irritation of the trigeminal nerve, typically affecting one side of the face with sudden, sharp, shooting pain. G50.0 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering nerve, nerve root and plexus disorders (g50-g59).

G50.0 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

This code does not map to a CMS-HCC V28 payment category. Capture depends on documentation that supports the diagnosis; verify the HCC assignment against the current CMS mapping for the applicable payment year. Coders reviewing G50.0 should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G50.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Specify laterality (right, left, or bilateral) when coding trigeminal neuralgia for complete documentation
•Document whether the condition is idiopathic or secondary to another condition

Clinical Significance

Trigeminal neuralgia is a severe, episodic facial pain condition characterized by sudden, shock-like, stabbing pain in the distribution of one or more branches of the trigeminal nerve (cranial nerve V). It is one of the most painful conditions known and significantly impacts quality of life, eating, speaking, and daily activities. Accurate coding supports authorization of specialized treatments including anticonvulsants, neurosurgical interventions, and advanced imaging.

Documentation Requirements

✓Paroxysmal attacks of facial pain lasting fractions of a second to 2 minutes
✓Pain distribution following trigeminal nerve branches (V1 ophthalmic, V2 maxillary, V3 mandibular)
✓Pain characteristics: intense, sharp, superficial, stabbing, or electric shock-like
✓Trigger zones or triggering activities identified (chewing, talking, light touch, brushing teeth)
✓Classification as classic (neurovascular compression), secondary (structural lesion), or idiopathic
✓MRI results to evaluate for neurovascular compression or secondary causes (MS, tumor)
✓Current treatment regimen (carbamazepine, oxcarbazepine, surgical options)

Commonly Confused Codes

•G50.1 (Atypical facial pain): continuous, poorly localized facial pain without the paroxysmal shock-like quality of trigeminal neuralgia
•G50.8 (Other disorders of trigeminal nerve): specific but not neuralgia; includes trigeminal neuropathy without pain paroxysms
•G50.9 (Disorder of trigeminal nerve, unspecified): less specific; always code to G50.0 when trigeminal neuralgia is diagnosed
•G44.89 (Other headache syndrome): headache disorders; trigeminal neuralgia is facial pain, not headache
•K08.89 (Other specified disorders of teeth and supporting structures): dental pain is a common misdiagnosis for trigeminal neuralgia