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

ICD-10 G55

Billable / Specific

Nerve root and plexus compressions in diseases classified elsewhere

G55
Block
0
Synonyms
647
LCDs
18
Payer Policies
52
Linked CPTs

About ICD-10-CM G55

ICD-10-CM code G55 represents Nerve root and plexus compressions in diseases classified elsewhere. This is a billable/specific code in the Nervous System chapter (block G55). The 2026 edition of ICD-10-CM G55 became effective on October 1, 2025.

Type 1 Excludes

Pure excludes, these codes can never be coded together with G55. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • nerve root compression (due to) (in) ankylosing spondylitis (M45.-)
  • nerve root compression (due to) (in) dorsopathies (M53.-, M54.-)
  • nerve root compression (due to) (in) intervertebral disc disorders (M50.1.-, M51.1.-)
  • nerve root compression (due to) (in) spondylopathies (M46.-, M48.-)
  • nerve root compression (due to) (in) spondylosis (M47.0-, M47.2.-)

Coding Notes

Code First

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

Medicare LCD Coverage for G55

Local Coverage Determinations (LCDs) from CMS MACs that list G55 as a covered diagnosis.

647 LCDs

Showing top 10 of 647 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98942 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98940 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98941 →
CMS LCD: Billing and Coding: Chiropractic Services
Article ID: 56273, Effective: 2025-08-28 00:00:00, 315 covered, 0 non-covered
CPT 98943 →
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 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing G55.

18 policies

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 G55

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

52 linkages
  • 72148 MRI lumbar spine without contrast — low back pain, lumbago, lumbar radiculopathy, lumbar disc herniation, spinal stenosis, lumbar sprain, spondylosis Radiology
  • 72141 MRI cervical spine without contrast — cervicalgia, cervical radiculopathy, cervical disc disorder, spinal stenosis cervical, cervical sprain, spondylosis Radiology
  • 64483 Transforaminal epidural injection lumbar — low back pain, lumbosacral radiculopathy, lumbar disc herniation, nerve root compression, spinal stenosis, spondylosis Pain Management
  • 62322 Interlaminar epidural injection lumbar — low back pain, radiculopathy, cervicalgia, disc herniation, spinal stenosis, spondylosis Pain Management
  • 64596 CMS LCD: Billing and Coding: Peripheral Nerve Stimulation CMS LCD
  • 64598 CMS LCD: Billing and Coding: Peripheral Nerve Stimulation CMS LCD
  • 64570 CMS LCD: Billing and Coding: Peripheral Nerve Stimulation CMS LCD
  • 64597 CMS LCD: Billing and Coding: Peripheral Nerve Stimulation CMS LCD
  • 64569 CMS LCD: Billing and Coding: Peripheral Nerve Stimulation CMS LCD
  • 64581 CMS LCD: Billing and Coding: Peripheral Nerve Stimulation CMS LCD

Convert G55 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
G55 3538 10000

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

ICD-10 G55, Billing FAQ

Is ICD-10 code G55 billable? +

Yes, G55 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for G55? +

Type 1 Excludes (never code together with G55): nerve root compression (due to) (in) ankylosing spondylitis (M45.-); nerve root compression (due to) (in) dorsopathies (M53.-, M54.-); nerve root compression (due to) (in) intervertebral disc disorders (M50.1.-, M51.1.-)

What CPT codes are commonly billed with G55? +

Procedures frequently paired with G55 include: 72148, 72141, 64483, 62322, 64596.

What ICD-9 codes does G55 map to? +

Per CMS GEMs, G55 maps to ICD-9 codes: 3538. 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 July 17, 2026.

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