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ICD-10 Guide
ICD-10 CodesG56.3

G56.3

Billable

Lesion of radial nerve

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

Code Description

ICD-10 G56.3 is a billable code used to indicate a diagnosis of lesion of radial nerve.

Key Diagnostic Point:

A lesion of the radial nerve can result from various causes, including trauma, compression, or systemic diseases. The radial nerve is responsible for the extension of the elbow, wrist, and fingers, and its injury can lead to significant functional impairment. Clinically, patients may present with wrist drop, weakness in elbow extension, and sensory loss in the posterior arm and forearm, as well as the radial aspect of the hand. Diagnosis typically involves a thorough clinical examination, nerve conduction studies, and electromyography to assess the extent of nerve damage and to rule out other neuropathies. Treatment may include physical therapy, splinting, and in some cases, surgical intervention to relieve compression or repair the nerve. Understanding the underlying cause of the lesion is crucial for effective management and rehabilitation. 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

  • Differentiating between types of nerve lesions (e.g., traumatic vs. compressive)
  • Understanding associated symptoms and their implications for treatment
  • Interpreting nerve conduction studies and their results
  • Documenting the extent of functional impairment

Audit Risk Factors

  • Inadequate documentation of the cause of the nerve lesion
  • Failure to include results from nerve conduction studies
  • Misclassification of the type of nerve injury
  • Lack of clarity in the extent of functional impairment

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, results of nerve conduction studies, and treatment plans.

Common Clinical Scenarios

Patients presenting with wrist drop, pain in the arm, or sensory deficits.

Billing Considerations

Ensure that all neurological deficits are documented to support the diagnosis.

Orthopedics

Documentation Requirements

Surgical notes if applicable, imaging studies, and post-operative assessments.

Common Clinical Scenarios

Patients with radial nerve injuries due to fractures or dislocations.

Billing Considerations

Document the mechanism of injury and any surgical interventions performed.

Coding Guidelines

Inclusion Criteria

Use G56.3 When
  • Follow the official ICD
  • CM coding guidelines for neurological disorders
  • Ensure that the documentation supports the diagnosis and includes details about the patient's symptoms, diagnostic tests, and treatment plans

Exclusion Criteria

Do NOT use G56.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

959.9CPT Code

Nerve conduction study

Clinical Scenario

Used to evaluate the function of the radial nerve in patients with suspected lesions.

Documentation Requirements

Results of the nerve conduction study must be documented in the patient's medical record.

Specialty Considerations

Neurologists should ensure that the study is performed and interpreted correctly.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of nerve lesions, improving the accuracy of diagnoses and treatment plans. G56.3 provides a clear classification for radial nerve lesions, facilitating better tracking of patient outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of nerve lesions, improving the accuracy of diagnoses and treatment plans. G56.3 provides a clear classification for radial nerve lesions, facilitating better tracking of patient outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of nerve lesions, improving the accuracy of diagnoses and treatment plans. G56.3 provides a clear classification for radial nerve lesions, facilitating better tracking of patient outcomes and resource allocation.

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 radial nerve lesions?

Common causes include trauma (such as fractures), compression (from prolonged pressure or tumors), and systemic diseases like diabetes that can lead to neuropathy.