ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 G54.5

Billable / Specific

Neuralgic amyotrophy

G54
Block
2
Synonyms
634
LCDs
18
Payer Policies
38
Linked CPTs

About ICD-10-CM G54.5

ICD-10-CM code G54.5 represents Neuralgic amyotrophy. This is a billable/specific code in the Nervous System chapter (block G54). The 2026 edition of ICD-10-CM G54.5 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under G54.5. Per CMS ICD-10-CM Tabular 2026.

  • Parsonage-Aldren-Turner syndrome
  • Shoulder-girdle neuritis

Type 1 Excludes

Pure excludes, these codes can never be coded together with G54.5. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • neuralgic amyotrophy in diabetes mellitus (E08-E13 with .44)

Medicare LCD Coverage for G54.5

Local Coverage Determinations (LCDs) from CMS MACs that list G54.5 as a covered diagnosis.

634 LCDs

Showing top 10 of 634 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95909 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95887 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95912 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95999 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95910 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95870 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95860 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95913 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT 95869 →
CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography
Article ID: 57668, Effective: 2025-10-01 00:00:00, 1629 covered, 0 non-covered
CPT G0255 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing G54.5.

18 policies

1 Cigna

Electrodiagnostic Testing (EMG/NCV) - (CPG129)
Policy ID: CPG129_EMG_NCV_SSEP

5 Medicare

Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Home Health Physical Therapy
Policy ID: ART-53058
Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065
Billing and Coding: Nerve Conduction Studies and Electromyography
Policy ID: ART-54095

CPT Codes Commonly Billed with G54.5

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

38 linkages
  • G0151 CMS LCD: Billing and Coding: Home Health Physical Therapy CMS LCD
  • G0159 CMS LCD: Billing and Coding: Home Health Physical Therapy CMS LCD
  • G2168 CMS LCD: Billing and Coding: Home Health Physical Therapy CMS LCD
  • G0157 CMS LCD: Billing and Coding: Home Health Physical Therapy CMS LCD
  • 98977 CMS LCD: Billing and Coding: Physical Therapy - Home Health CMS LCD
  • G2251 CMS LCD: Billing and Coding: Physical Therapy - Home Health CMS LCD
  • 98970 CMS LCD: Billing and Coding: Physical Therapy - Home Health CMS LCD
  • 98976 CMS LCD: Billing and Coding: Physical Therapy - Home Health CMS LCD
  • 98981 CMS LCD: Billing and Coding: Physical Therapy - Home Health CMS LCD
  • 98972 CMS LCD: Billing and Coding: Physical Therapy - Home Health CMS LCD

Convert G54.5 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
G54.5 3535 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 G54.5, Billing FAQ

Is ICD-10 code G54.5 billable? +

Yes, G54.5 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to G54.5? +

ICD-10 G54.5 includes: Parsonage-Aldren-Turner syndrome; Shoulder-girdle neuritis.

What codes are Type 1 Excludes for G54.5? +

Type 1 Excludes (never code together with G54.5): neuralgic amyotrophy in diabetes mellitus (E08-E13 with .44)

What CPT codes are commonly billed with G54.5? +

Procedures frequently paired with G54.5 include: G0151, G0159, G2168, G0157, 98977.

What ICD-9 codes does G54.5 map to? +

Per CMS GEMs, G54.5 maps to ICD-9 codes: 3535. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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