ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesG54.0

G54.0

Billable

Brachial plexus disorders

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 G54.0 is a billable code used to indicate a diagnosis of brachial plexus disorders.

Key Diagnostic Point:

Brachial plexus disorders encompass a range of conditions affecting the brachial plexus, a network of nerves that originates from the spinal cord in the neck and extends into the arm. These disorders can result from trauma, compression, inflammation, or congenital anomalies, leading to symptoms such as pain, weakness, and sensory loss in the upper extremities. Common causes include traumatic injuries, such as those sustained in motor vehicle accidents, or conditions like thoracic outlet syndrome, where nerves are compressed as they pass through the thoracic outlet. Neuropathies affecting the brachial plexus can also arise from systemic diseases like diabetes or infections. Diagnosis often involves a combination of clinical evaluation, imaging studies, and nerve conduction studies to assess the function of the affected nerves. Treatment may include physical therapy, pain management, and in some cases, surgical intervention to relieve compression or repair damaged nerves. Accurate coding is essential for proper reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes (trauma, congenital, systemic diseases)
  • Need for detailed documentation of symptoms and clinical findings
  • Potential for co-existing conditions affecting coding
  • Variability in treatment approaches and their documentation

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to specify the cause of the brachial plexus disorder
  • Misclassification of the disorder as a different neuropathy
  • Lack of supporting diagnostic tests in the medical record

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, including motor and sensory assessments.

Common Clinical Scenarios

Patients presenting with upper limb weakness, pain, or sensory changes following trauma or systemic illness.

Billing Considerations

Ensure documentation includes the specific nerves affected and the functional impact on the patient.

Orthopedic Surgery

Documentation Requirements

Surgical notes detailing the procedure performed, indications, and post-operative assessments.

Common Clinical Scenarios

Surgical intervention for brachial plexus injuries or decompression due to thoracic outlet syndrome.

Billing Considerations

Document the rationale for surgery and any pre-operative imaging findings.

Coding Guidelines

Inclusion Criteria

Use G54.0 When
  • According to ICD
  • 10 coding guidelines, G54
  • 0 should be used when the brachial plexus disorder is confirmed and documented
  • It is important to include any relevant diagnostic tests and clinical findings to support the diagnosis

Exclusion Criteria

Do NOT use G54.0 When
  • Exclusion criteria include conditions that are not directly related to the brachial plexus

Related ICD-10 Codes

Related CPT Codes

95903CPT Code

Nerve conduction study, upper extremity

Clinical Scenario

Used to evaluate nerve function in patients with suspected brachial plexus disorders.

Documentation Requirements

Document the specific nerves tested and the findings.

Specialty Considerations

Neurologists should ensure that the rationale for the study is clearly documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of brachial plexus disorders, improving the ability to capture the complexity of these conditions and their underlying causes. This specificity aids in better patient management and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of brachial plexus disorders, improving the ability to capture the complexity of these conditions and their underlying causes. This specificity aids in better patient management and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common causes of brachial plexus disorders?

Common causes include traumatic injuries, such as those from accidents, compression syndromes like thoracic outlet syndrome, and systemic conditions such as diabetes or infections.

How is a brachial plexus disorder diagnosed?

Diagnosis typically involves a thorough clinical evaluation, imaging studies (like MRI), and nerve conduction studies to assess nerve function.