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ICD-10 Guide
ICD-10 CodesG54.1

G54.1

Billable

Lumbosacral plexus disorders

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

Code Description

ICD-10 G54.1 is a billable code used to indicate a diagnosis of lumbosacral plexus disorders.

Key Diagnostic Point:

Lumbosacral plexus disorders refer to a range of conditions affecting the lumbosacral plexus, a network of nerves that supplies the lower limbs and pelvic region. These disorders can arise from various etiologies, including trauma, compression, inflammation, or systemic diseases such as diabetes. Symptoms may include pain, weakness, numbness, or tingling in the lower back, buttocks, thighs, and legs. The lumbosacral plexus is particularly vulnerable to entrapment due to its anatomical location, and conditions such as piriformis syndrome or lumbar disc herniation can lead to significant nerve compression. Diagnosis often involves a thorough clinical examination, nerve conduction studies, and imaging techniques to assess nerve integrity and identify potential compressive lesions. Treatment options may include physical therapy, medications for pain management, and in some cases, surgical intervention to relieve nerve compression. Accurate coding is essential for proper reimbursement and to ensure that the underlying causes of the symptoms are appropriately documented.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes (trauma, systemic diseases)
  • Overlap with other neuropathies and entrapment syndromes
  • Need for detailed documentation of symptoms and diagnostic tests
  • Potential for multiple codes to describe associated conditions

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to specify the underlying cause of the plexus disorder
  • Incorrect linkage of diagnosis to treatment procedures
  • Use of unspecified codes when more specific codes are available

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, results of nerve conduction studies, and imaging reports.

Common Clinical Scenarios

Patients presenting with lower limb weakness, pain, or sensory changes following trauma or with a history of diabetes.

Billing Considerations

Ensure that all relevant diagnostic tests are documented to support the diagnosis and coding.

Orthopedics

Documentation Requirements

Surgical notes, imaging studies, and pre-operative assessments.

Common Clinical Scenarios

Patients with lumbar disc herniation or hip impingement presenting with lumbosacral plexus symptoms.

Billing Considerations

Document the relationship between orthopedic conditions and nerve symptoms to support coding.

Coding Guidelines

Inclusion Criteria

Use G54.1 When
  • According to ICD
  • 10 coding guidelines, G54
  • 1 should be used when the lumbosacral plexus is specifically implicated in the patient's symptoms
  • It is important to document the clinical findings and any diagnostic tests performed to support the use of this code

Exclusion Criteria

Do NOT use G54.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95903CPT Code

Nerve conduction study, each nerve

Clinical Scenario

Used to evaluate nerve function in patients suspected of having lumbosacral plexus disorders.

Documentation Requirements

Document the specific nerves tested and the results of the study.

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 lumbosacral plexus disorders, improving the ability to capture the complexity of these conditions and their underlying causes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of lumbosacral plexus disorders, improving the ability to capture the complexity of these conditions and their underlying causes.

Reimbursement & Billing Impact

reimbursement.

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 lumbosacral plexus disorders?

Common causes include trauma, compression from tumors, herniated discs, and systemic conditions such as diabetes.

How is a lumbosacral plexus disorder diagnosed?

Diagnosis typically involves a clinical examination, nerve conduction studies, and imaging studies such as MRI to assess nerve integrity.