G54.6 Phantom limb syndrome with pain

BillableCMS-HCC V28: HCC 409Chapter 6

Check coverage with this diagnosis

Instructional notes

Chapter 6

Excludes2Not included here: the patient may have both; report both when both are present.

certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Section G50-G59

Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.

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-)

G54

Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.

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.-)

Chapter 6: Diseases of the nervous system · G50-G59 Nerve, nerve root and plexus disorders (G50-G59)

Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.

Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.