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ICD-10 Guide
ICD-10 CodesG56.90

G56.90

Billable

Unspecified mononeuropathy of unspecified upper limb

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

Code Description

ICD-10 G56.90 is a billable code used to indicate a diagnosis of unspecified mononeuropathy of unspecified upper limb.

Key Diagnostic Point:

Unspecified mononeuropathy of the upper limb refers to a condition characterized by damage or dysfunction of a single peripheral nerve in the upper limb, which can lead to symptoms such as pain, weakness, numbness, or tingling. This condition is often caused by various factors including trauma, repetitive motion, or compression of the nerve. The term 'unspecified' indicates that the exact nerve affected is not identified, which can complicate diagnosis and treatment. Common examples of mononeuropathies include carpal tunnel syndrome, ulnar nerve entrapment, and radial nerve palsy. Diagnosis typically involves a thorough clinical examination, patient history, and may include nerve conduction studies to assess the electrical activity of the nerve. Treatment options vary based on the underlying cause and may include physical therapy, medications for pain relief, or surgical intervention in severe cases. Accurate coding is essential for proper reimbursement and to ensure that the patient's medical record reflects the complexity of their condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity regarding the affected nerve
  • Variability in symptoms and presentation
  • Potential overlap with other neuropathic conditions
  • Need for comprehensive documentation to support the diagnosis

Audit Risk Factors

  • Insufficient documentation of symptoms
  • Lack of clear diagnostic criteria met
  • Inadequate linkage between diagnosis and treatment
  • Failure to specify the affected nerve when possible

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, including sensory and motor assessments.

Common Clinical Scenarios

Patients presenting with numbness or weakness in the upper limb without a clear diagnosis.

Billing Considerations

Ensure that all relevant diagnostic tests, including nerve conduction studies, are documented.

Orthopedics

Documentation Requirements

Documentation of physical examination findings, imaging studies, and treatment plans.

Common Clinical Scenarios

Patients with upper limb pain or dysfunction potentially due to nerve entrapment.

Billing Considerations

Document any surgical interventions or conservative management strategies employed.

Coding Guidelines

Inclusion Criteria

Use G56.90 When
  • According to ICD
  • 10 guidelines, G56
  • 90 should be used when the specific nerve affected is not documented
  • Coders should ensure that all relevant clinical information is captured to support the use of this unspecified code

Exclusion Criteria

Do NOT use G56.90 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95903CPT Code

Nerve conduction study, motor

Clinical Scenario

Used to evaluate the function of the affected nerve in cases of suspected mononeuropathy.

Documentation Requirements

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

Specialty Considerations

Neurologists should ensure that the study results are clearly linked to the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of neuropathies, but the use of unspecified codes like G56.90 remains common due to the complexity of diagnosing specific nerve conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neuropathies, but the use of unspecified codes like G56.90 remains common due to the complexity of diagnosing specific nerve conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of neuropathies, but the use of unspecified codes like G56.90 remains common due to the complexity of diagnosing specific nerve conditions.

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

When should I use G56.90?

Use G56.90 when a patient presents with symptoms of mononeuropathy in the upper limb, but the specific nerve affected is not documented or identified.