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ICD-10 Guide
ICD-10 CodesG56.80

G56.80

Billable

Other specified mononeuropathies of unspecified upper limb

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

Code Description

ICD-10 G56.80 is a billable code used to indicate a diagnosis of other specified mononeuropathies of unspecified upper limb.

Key Diagnostic Point:

G56.80 refers to other specified mononeuropathies affecting the unspecified upper limb, which can include a variety of conditions that affect a single nerve or group of nerves. These neuropathies may arise from various etiologies, including trauma, compression, or systemic diseases. Common examples include nerve entrapments such as carpal tunnel syndrome, ulnar nerve entrapment, or radial nerve palsy. Symptoms may include pain, numbness, tingling, and weakness in the affected area. Diagnosis often involves a thorough clinical examination, patient history, and may include nerve conduction studies (NCS) to assess the electrical activity of the nerves. These studies help to determine the presence and extent of nerve damage, guiding treatment options. Treatment may involve conservative measures such as physical therapy, splinting, or corticosteroid injections, and in some cases, surgical intervention may be necessary to relieve nerve compression. 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 potential underlying causes
  • Need for detailed documentation of symptoms
  • Differentiation from other neuropathies
  • Potential for co-existing conditions

Audit Risk Factors

  • Insufficient documentation of symptoms
  • Lack of clear diagnosis
  • Inconsistent use of codes for similar conditions
  • Failure to document nerve conduction studies

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, results of nerve conduction studies, and patient history.

Common Clinical Scenarios

Patients presenting with numbness and tingling in the upper limb, suspected nerve entrapment syndromes.

Billing Considerations

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

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients with upper limb injuries leading to nerve compression or entrapment.

Billing Considerations

Document the mechanism of injury and any surgical interventions performed.

Coding Guidelines

Inclusion Criteria

Use G56.80 When
  • According to ICD
  • 10 guidelines, G56
  • 80 should be used when the specific mononeuropathy affecting the upper limb is not classified elsewhere
  • Coders must ensure that the documentation supports the diagnosis and that other more specific codes are not applicable

Exclusion Criteria

Do NOT use G56.80 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95903CPT Code

Nerve conduction study, upper limb

Clinical Scenario

Used to evaluate suspected mononeuropathies.

Documentation Requirements

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

Specialty Considerations

Neurologists should ensure that the study results correlate with clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of neuropathies, improving the ability to capture the complexity of these conditions. G56.80 provides a means to code unspecified mononeuropathies, which may have been underrepresented in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neuropathies, improving the ability to capture the complexity of these conditions. G56.80 provides a means to code unspecified mononeuropathies, which may have been underrepresented in ICD-9.

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 G56.80?

Common causes include nerve entrapments, trauma, and systemic diseases such as diabetes. Each case should be evaluated individually to determine the underlying cause.

How do I differentiate G56.80 from other neuropathy codes?

G56.80 is used when the specific nerve affected is not identified. If a specific mononeuropathy is diagnosed, a more specific code should be used.