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G55 ICD-10-CM Code: Nerve root and plexus compressions in diseases classified elsewhere

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
10 Excludes1 · 2 code-first instructions

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 073 — CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC (MDC 01)
  • MS-DRG 074 — CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC (MDC 01)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for G55 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on G55 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Code First

Underlying conditions that must be sequenced before this code.

  • underlying disease, such as:
  • neoplasm (C00-D49)

Coder workflow for G55

MedCoder structured workflow — derived from this code’s own official record

Before you code G55

  1. G55 is a manifestation code (“in diseases classified elsewhere”). Confirm the underlying condition is documented and sequence it first; a manifestation code is not reported as the first-listed or principal diagnosis. The etiology/manifestation convention (Guidelines I.A.13).

    See the official tabular notes · Guide: Manifestation codes and Code First sequencing →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with G55. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in G55’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewM45, M53, M54, M50.1, M51.1, M46

  2. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then G55.
    No → A manifestation code needs its underlying condition — query before reporting it.

Consider G55. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The underlying (etiologic) condition
Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).

Official instructions as workflow

  • Excludes1 — check before selecting G55(10 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with G55: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareM45, M53, M54, M50.1, M51.1, M46

    See the official tabular notes · Guidelines I.A.12.a

  • Code First — sequencing check(2 notes)

    Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before G55. Do not add an underlying condition the record does not document.

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition G55 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewM45, M53, M54, M50.1, M51.1, M46

Documentation: The underlying condition the Code First note names is documented alongside this condition.

Coding question: How are the two sequenced?

Path: Review the Code First note.

Reason: The underlying condition is sequenced first and the manifestation follows (Guidelines I.A.13).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse G55 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of G55 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • M45— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of nerve root compression (due to) (in) ankylosing spondylitis moves the case to M45; the two are not reported together unless documented as unrelated.

    Full comparison: G55 vs M45 →

  • M53— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of nerve root compression (due to) (in) dorsopathies moves the case to M53; the two are not reported together unless documented as unrelated.

    Full comparison: G55 vs M53 →

  • M54— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of nerve root compression (due to) (in) dorsopathies moves the case to M54; the two are not reported together unless documented as unrelated.

    Full comparison: G55 vs M54 →

  • M50.1— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of nerve root compression (due to) (in) intervertebral disc disorders moves the case to M50.1; the two are not reported together unless documented as unrelated.

    Full comparison: G55 vs M50.1 →

  • M51.1— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of nerve root compression (due to) (in) intervertebral disc disorders moves the case to M51.1; the two are not reported together unless documented as unrelated.

    Full comparison: G55 vs M51.1 →

  • M46— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of nerve root compression (due to) (in) spondylopathies moves the case to M46; the two are not reported together unless documented as unrelated.

    Full comparison: G55 vs M46 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Code Overview

Nerve root and plexus compressions in diseases classified elsewhere is a billable ICD-10-CM diagnosis code (G55).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

  • Principal-diagnosis restriction. This is a manifestation code: the Medicare Code Editor requires the underlying condition (etiology) to be sequenced first, with this code reported after it.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name G55 or its code family, from the CMS ICD-10-CM tabular instructional notes and the CMS ICD-10-CM Index to Diseases and Injuries. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Code Also instruction: G96.81 — Intracranial hypotension.

These codes suggest coding this condition alongside when both are present.

Referenced by 2 Index etiology/manifestation pairs across 2 chapters: D49.9 — Neoplasm of unspecified behavior of unspecified site, M51.9 — Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder.

The ICD-10-CM Index lists these etiology codes with this code in brackets — the manifestation, reported second.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 2 MS-DRGs: DRG 073 (MDC 01), DRG 074 (MDC 01).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):NVS017 — Nerve and nerve root disorders.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Principal diagnosis restriction (Medicare Code Editor)

Manifestation code — the underlying condition is sequenced first.

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Nerve and nerve root disorders).

G54.0 — Brachial plexus disorders, G54.1 — Lumbosacral plexus disorders, G54.2 — Cervical root disorders, not elsewhere classified, G54.3 — Thoracic root disorders, not elsewhere classified, G54.4 — Lumbosacral root disorders, not elsewhere classified, G54.5 — Neuralgic amyotrophy, G54.6 — Phantom limb syndrome with pain, G54.7 — Phantom limb syndrome without pain, G54.8 — Other nerve root and plexus disorders, G54.9 — Nerve root and plexus disorder, unspecified, G56.00 — Carpal tunnel syndrome, unspecified upper limb, G56.01 — Carpal tunnel syndrome, right upper limb, G56.02 — Carpal tunnel syndrome, left upper limb, G56.03 — Carpal tunnel syndrome, bilateral upper limbs, G56.10 — Other lesions of median nerve, unspecified upper limb, G56.11 — Other lesions of median nerve, right upper limb, G56.12 — Other lesions of median nerve, left upper limb, G56.13 — Other lesions of median nerve, bilateral upper limbs, G56.20 — Lesion of ulnar nerve, unspecified upper limb, G56.21 — Lesion of ulnar nerve, right upper limb, +94 more

Contextual Map

Every relationship of G55 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run G55 with these 9 related codes in Claim Check

Hierarchy

Excludes1 (12)

Referenced by Code Also instructions

  • G96.81 — Intracranial hypotension[Code Also]: “Nerve root and compressions in diseases classified elsewhere (G55)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Index etiology/manifestation pairs

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 01 — Diseases and Disorders of the Nervous System[MDC crossing]: “Diseases and Disorders of the Nervous System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 8,919 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "G55 — Nerve root and plexus compressions in diseases classified elsewhere." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/g55-nerve-root-and-plexus-compressions-in-diseases-classified-elsewhere

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Nerve root and plexus compressions in diseases classified elsewhere

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.