G54.1 ICD-10-CM Code: Lumbosacral plexus disorders
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FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Nerve, nerve root and plexus disorders (G50-G59)
G54.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceLumbosacral plexus disorders
Damage or dysfunction of the lumbosacral plexus, a network of nerves in the lower back and pelvis that controls movement and sensation in the legs.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for G54.1 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for G54.1 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for G54.1 in this effective period.
Excludes 1
Official- 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)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for G54.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for G54.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for G54.1 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is G54.1 an HCC code?
No. G54.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
G54.1 is the ICD-10-CM diagnosis code for lumbosacral plexus disorders. Damage or dysfunction of the lumbosacral plexus, a network of nerves in the lower back and pelvis that controls movement and sensation in the legs. G54.1 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).
G54.1 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.
Specify laterality (right, left, bilateral) when documented.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G54.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Specify laterality (right, left, bilateral) when documented
- •Distinguish from radiculopathy by documenting plexus involvement rather than single nerve root