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G54.6 vs G89.22

G54.6 (Phantom limb syndrome with pain) compared with G89.22 (Chronic post-thoracotomy pain), from the official CMS tabular data.

Summary

These codes can be reported together when both conditions are documented, because G89.22 lists G54.6 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named.G54.6 is “Phantom limb syndrome with pain”; G89.22 is “Chronic post-thoracotomy pain”.

Registry fact

Can these codes be reported together?

Yes, when both are documented.G89.22 lists G54.6 under Excludes2: “phantom limb syndrome with pain (G54.6)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. G54.6 carries 15 Excludes1 notes and G89.22 carries 11 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.G89.22’s tabular entry: “phantom limb syndrome with pain (G54.6)”. The note covers G54.6.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

No.Both are billable codes, and neither contains the other.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Excludes2 relationship

G89.22
Chronic post-thoracotomy pain
↔
G54.6
Phantom limb syndrome with pain

What we found

Yes, when both are documented.G89.22 carries an Excludes2 note covering G54.6: “phantom limb syndrome with pain (G54.6)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

G54.6Phantom limb syndrome with painG89.22Chronic post-thoracotomy pain
Billing statusBillableBillable
ClassificationG00-G99 — Diseases of the Nervous System (G00-G99)G00-G99 — Diseases of the Nervous System (G00-G99)
DefinitionPhantom limb syndrome with pain is a billable ICD-10-CM diagnosis code (G54.6).Chronic post-thoracotomy pain is a billable ICD-10-CM diagnosis code (G89.22).
Excludes1
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.-)
current traumatic nerve, nerve root and plexus disorders - see Injury, nerve by body region
neuralgia NOS (M79.2)
neuritis NOS (M79.2)
peripheral neuritis in pregnancy (O26.82-)
radiculitis NOS (M54.1-)
causalgia, lower limb (G57.7-)
causalgia, upper limb (G56.4-)
central pain syndrome (G89.0)
chronic pain syndrome (G89.4)
complex regional pain syndrome II, lower limb (G57.7-)
complex regional pain syndrome II, upper limb (G56.4-)
neoplasm related chronic pain (G89.3)
reflex sympathetic dystrophy (G90.5-)
generalized pain NOS (R52)
pain disorders exclusively related to psychological factors (F45.41)
pain NOS (R52)
Excludes2—
atypical face pain (G50.1)
headache syndromes (G44.-)
localized pain, unspecified type - code to pain by site, such as:
abdomen pain (R10.-)
back pain (M54.9)
breast pain (N64.4)
chest pain (R07.1-R07.9)
ear pain (H92.0-)
eye pain (H57.1)
headache (R51.9)
joint pain (M25.5-)
limb pain (M79.6-)
lumbar region pain (M54.5-)
painful urination (R30.9)
pelvic and perineal pain (R10.2-)
shoulder pain (M25.51-)
spine pain (M54.-)
throat pain (R07.0)
tongue pain (K14.6)
tooth pain (K08.8)
renal colic (N23)
migraines (G43.-)
myalgia (M79.1-)
pain from prosthetic devices, implants, and grafts (T82.84, T83.84, T84.84, T85.84-)
phantom limb syndrome with pain (G54.6)
vulvar vestibulitis (N94.810)
vulvodynia (N94.81-)
Code also—
related psychological factors associated with pain (F45.42)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources