What is ICD-10 code G54.7?

G54.7 is the ICD-10-CM diagnosis code for Phantom limb syndrome without pain. A condition where a person feels sensations in a limb that has been amputated or lost, but without pain accompanying those sensations. It belongs to the ICD-10-CM chapter for diseases of the nervous system (g00-g99). G54.7 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. G54.7 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. G54.7 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. G54.7 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 G54.7?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For G54.7, V28 maps to Amputation Status, Lower Limb/Amputation Complications at RAF 0.350 while V24 mapped to Amputation Status, Lower Limb/Amputation Complications at RAF 0.350. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting G54.7?

Distinguish from G54.6 (phantom limb syndrome with pain) - this code is specifically for painless phantom sensations Document which limb is affected if possible, though this code does not require laterality specification Because G54.7 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

G54.7 ICD-10 Code: Phantom limb syndrome without

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupG54.7Effective 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)

G54.7

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

Phantom limb syndrome without pain

A condition where a person feels sensations in a limb that has been amputated or lost, but without pain accompanying those sensations.

Buddy Insight

Phantom limb syndrome without pain involves non-painful phantom sensations such as perceived movement, itching, pressure, or tingling in an amputated or absent limb.

CMS-HCC V28

Mapped

HCC 409

Amputation Status, Lower Limb...

RAF 0.350

CMS-HCC V24

Mapped

HCC 189

Amputation Status, Lower Limb...

RAF 0.350

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 189

Amputation Status, Lower Limb...

RAF 0.0

RXHCC

Not risk-adjusted for this model/period.

RAF 0

Code Trumping

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Compare selected patient codes to show trumped or trumps impact.

Code Book Path

Official

G54Nerve root and plexus disorders

G54.7Phantom limb syndrome without pain

Inclusion Terms

Official

Phantom limb syndrome NOS

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for G54.7 in this effective period.

Related Child Codes

Official

G54.0Brachial plexus disorders

G54.1Lumbosacral plexus disorders

G54.2Cervical root disorders, not elsewhere classified

G54.3Thoracic root disorders, not elsewhere classified

G54.4Lumbosacral root disorders, not elsewhere classified

Includes

Official

ICD-10-CM does not list Includes notes for G54.7 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

Official

ICD-10-CM does not list Code First sequencing instructions for G54.7 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for G54.7 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for G54.7 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

History of limb amputation or congenital limb absence

Description of phantom sensations: type (tingling, itching, movement, pressure, temperature, posture awareness)

Documentation that sensations are NOT painful (distinguishes from G54.6)

Frequency and impact on daily activities and prosthetic use

MEAT Support

HCC Buddy guidance

History of limb amputation or congenital limb absence

Description of phantom sensations: type (tingling, itching, movement, pressure, temperature, posture awareness)

Documentation that sensations are NOT painful (distinguishes from G54.6)

Frequency and impact on daily activities and prosthetic use

Audit Caution

HCC Buddy guidance

Coding G54.7 when the patient actually has phantom PAIN — always assess and document the pain component separately

Not capturing phantom limb syndrome at all during encounters focused on prosthetic management

Using somatoform or psychological codes for a recognized neurological phenomenon

Confusing phantom limb sensations with stump neuroma or residual limb problems

Common Mistakes

HCC Buddy guidance

G54.6 (Phantom limb syndrome with pain) — painful phantom sensations require the WITH pain code for clinical accuracy

R20.2 (Paresthesia of skin) — generic sensory symptom; phantom limb sensation is specific to absent limb

T87.30-T87.9 (Complications of reattached extremity/amputation stump) — stump-related issues, not phantom sensations

F45.8 (Other somatoform disorders) — phantom limb is a neurological phenomenon, not somatoform

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 G54.7 an HCC code?

Yes. G54.7 maps to Amputation Status, Lower Limb/Amputation Complications under the CMS-HCC V28 risk adjustment model (and Amputation Status, Lower Limb/Amputation Complications under V24).

HCC Category Mapping

V28HCC 409, Amputation Status, Lower Limb/Amputation Complications

0.350

V24HCC 189, Amputation Status, Lower Limb/Amputation Complications

0.350

ESRDHCC 189, Amputation Status, Lower Limb/Amputation Complications

0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.

MEAT Criteria for G54.7

For G54.7to 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 G54.7 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

G54.7 is the ICD-10-CM diagnosis code for phantom limb syndrome without pain. A condition where a person feels sensations in a limb that has been amputated or lost, but without pain accompanying those sensations. G54.7 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).

Under the CMS-HCC V28 risk adjustment model, G54.7 maps to Amputation Status, Lower Limb/Amputation Complications (HCC 409) with a community, non-dual, aged base RAF weight of 0.350. The V24 model used during the PY2024–PY2025 transition mapped G54.7 the same way and at the same RAF weight. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Distinguish from G54.6 (phantom limb syndrome with pain) - this code is specifically for painless phantom sensations. Because G54.7 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G54.7 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Distinguish from G54.6 (phantom limb syndrome with pain) - this code is specifically for painless phantom sensations
•Document which limb is affected if possible, though this code does not require laterality specification

Clinical Significance

Phantom limb syndrome without pain involves non-painful phantom sensations such as perceived movement, itching, pressure, or tingling in an amputated or absent limb. While less distressing than painful phantom limb syndrome, these sensations affect body image, rehabilitation progress, and prosthetic adaptation. This code carries the same HCC mappings as the painful variant (V28 HCC 409, V24 HCC 189, both RAF 0.350), reflecting ongoing neurological complexity.

Documentation Requirements

✓History of limb amputation or congenital limb absence
✓Description of phantom sensations: type (tingling, itching, movement, pressure, temperature, posture awareness)
✓Documentation that sensations are NOT painful (distinguishes from G54.6)
✓Frequency and impact on daily activities and prosthetic use
✓Assessment of body image adaptation and psychological impact
✓Any treatment being used for non-painful phantom sensations
✓Functional assessment related to prosthetic fitting and use

Commonly Confused Codes

•G54.6 (Phantom limb syndrome with pain): painful phantom sensations require the WITH pain code for clinical accuracy
•R20.2 (Paresthesia of skin): generic sensory symptom; phantom limb sensation is specific to absent limb
•T87.30-T87.9 (Complications of reattached extremity/amputation stump): stump-related issues, not phantom sensations
•F45.8 (Other somatoform disorders): phantom limb is a neurological phenomenon, not somatoform
•G54.4 (Lumbosacral root disorders): nerve root pathology, not phantom limb phenomenon