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v1.0.0
ICD-10 Guide
ICD-10 CodesG54.3

G54.3

Billable

Thoracic root disorders, not elsewhere classified

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

Code Description

ICD-10 G54.3 is a billable code used to indicate a diagnosis of thoracic root disorders, not elsewhere classified.

Key Diagnostic Point:

Thoracic root disorders encompass a range of conditions affecting the thoracic spinal nerves, which can lead to pain, weakness, and sensory disturbances in the thoracic region. These disorders may arise from various etiologies, including trauma, degenerative diseases, infections, or tumors. Symptoms often include localized pain, paresthesia, and motor deficits, which can significantly impact a patient's quality of life. Diagnosis typically involves a thorough clinical evaluation, imaging studies, and nerve conduction studies to assess the integrity of the thoracic roots. Treatment may vary from conservative management, such as physical therapy and pain management, to surgical interventions in cases of severe compression or structural abnormalities. 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

  • Variability in clinical presentation and symptoms
  • Need for comprehensive documentation of neurological assessments
  • Differentiation from other nerve root disorders
  • Potential overlap with other thoracic conditions

Audit Risk Factors

  • Inadequate documentation of neurological findings
  • Failure to specify the exact thoracic root affected
  • Misclassification with cervical or lumbar root disorders
  • Lack of supporting diagnostic tests in the medical record

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with thoracic radiculopathy, post-surgical complications, or neuropathies.

Billing Considerations

Ensure clear documentation of the neurological deficits and correlation with imaging findings.

Orthopedics

Documentation Requirements

Surgical notes, pre-operative assessments, and post-operative follow-ups.

Common Clinical Scenarios

Patients with thoracic disc herniation or spinal stenosis requiring surgical intervention.

Billing Considerations

Document the surgical approach and any intraoperative findings that may affect coding.

Coding Guidelines

Inclusion Criteria

Use G54.3 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include details of the affected thoracic root and any associated conditions

Exclusion Criteria

Do NOT use G54.3 When
  • Exclude conditions that are specifically classified elsewhere

Related ICD-10 Codes

Related CPT Codes

95886CPT Code

Nerve conduction studies

Clinical Scenario

Used to evaluate nerve function in patients with suspected thoracic root disorders.

Documentation Requirements

Document the rationale for the study and the specific nerves tested.

Specialty Considerations

Neurologists should ensure comprehensive documentation of findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of thoracic root disorders, improving the accuracy of diagnoses and facilitating better patient management. G54.3 provides a distinct classification for conditions that may have previously been coded under more general terms.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of thoracic root disorders, improving the accuracy of diagnoses and facilitating better patient management. G54.3 provides a distinct classification for conditions that may have previously been coded under more general terms.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of thoracic root disorders, improving the accuracy of diagnoses and facilitating better patient management. G54.3 provides a distinct classification for conditions that may have previously been coded under more general terms.

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 symptoms associated with thoracic root disorders?

Common symptoms include localized thoracic pain, radiating pain, numbness, tingling, and weakness in the thoracic region. Patients may also experience sensory disturbances.

How is G54.3 differentiated from other nerve root disorders?

G54.3 is specifically used for thoracic root disorders, while cervical and lumbar root disorders are coded separately. Accurate documentation of the affected region is crucial.