G54
Non-Billable (Header)Nerve root and plexus disorders
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
What This Code Means
G54 is the ICD-10-CM diagnosis code for nerve root and plexus disorders. G54 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).
Header codes like G54 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at G54's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G54 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Excludes 1 — Do NOT code together
- 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.-)