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ICD-10 Guide
ICD-10 CodesG56.12

G56.12

Billable

Other lesions of median nerve, left upper limb

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

Code Description

ICD-10 G56.12 is a billable code used to indicate a diagnosis of other lesions of median nerve, left upper limb.

Key Diagnostic Point:

G56.12 refers to lesions affecting the median nerve in the left upper limb, which can result from various conditions such as trauma, compression, or systemic diseases. The median nerve is crucial for motor and sensory functions in the hand, particularly in the thumb, index, middle fingers, and part of the ring finger. Lesions can lead to symptoms like pain, numbness, tingling, and weakness in the affected areas. Common causes include carpal tunnel syndrome, where the nerve is compressed at the wrist, or other forms of neuropathy that may arise from diabetes or inflammatory conditions. Diagnosis typically involves a thorough clinical examination, nerve conduction studies, and imaging if necessary. Treatment may vary from conservative management, such as splinting and physical therapy, to surgical interventions depending on the severity and underlying cause of the lesion. Accurate coding is essential for appropriate reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and symptoms of median nerve lesions
  • Differentiation from other neuropathies and entrapments
  • Need for precise documentation of clinical findings
  • Potential for multiple underlying causes

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to specify the exact location of the lesion
  • Misdiagnosis or coding of similar conditions
  • Lack of supporting diagnostic tests like nerve conduction studies

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, including sensory and motor assessments.

Common Clinical Scenarios

Patients presenting with numbness and tingling in the hand, weakness in grip strength, or pain radiating from the wrist.

Billing Considerations

Ensure that all relevant diagnostic tests, such as nerve conduction studies, are documented to support the diagnosis.

Orthopedics

Documentation Requirements

Surgical notes if applicable, imaging results, and physical examination findings.

Common Clinical Scenarios

Patients with median nerve lesions requiring surgical intervention or conservative management.

Billing Considerations

Document the rationale for surgical intervention and any pre-operative assessments performed.

Coding Guidelines

Inclusion Criteria

Use G56.12 When
  • According to ICD
  • 10 guidelines, G56
  • 12 should be used when there is clear documentation of lesions affecting the median nerve in the left upper limb
  • It is important to ensure that the documentation specifies the nature of the lesion and any associated symptoms

Exclusion Criteria

Do NOT use G56.12 When
  • Exclusion criteria include conditions that are specifically coded elsewhere

Related ICD-10 Codes

Related CPT Codes

95903CPT Code

Nerve conduction study, upper limb

Clinical Scenario

Used to confirm the diagnosis of median nerve lesions.

Documentation Requirements

Results of the nerve conduction study must be documented.

Specialty Considerations

Neurologists should ensure that the study is performed according to established protocols.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like median nerve lesions, improving the accuracy of patient records and reimbursement processes. G56.12 provides a clearer picture of the patient's condition compared to previous coding systems.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like median nerve lesions, improving the accuracy of patient records and reimbursement processes. G56.12 provides a clearer picture of the patient's condition compared to previous coding systems.

Reimbursement & Billing Impact

reimbursement processes. G56.12 provides a clearer picture of the patient's condition compared to previous coding systems.

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 median nerve lesions?

Common causes include trauma, repetitive strain injuries, systemic diseases like diabetes, and conditions such as rheumatoid arthritis.

How can I differentiate between G56.12 and G56.11?

G56.12 is used for other lesions of the median nerve, while G56.11 specifically refers to carpal tunnel syndrome. Documentation should clarify the nature of the lesion.