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ICD-10 Guide
ICD-10 CodesG56.91

G56.91

Billable

Unspecified mononeuropathy of right upper limb

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

Code Description

ICD-10 G56.91 is a billable code used to indicate a diagnosis of unspecified mononeuropathy of right upper limb.

Key Diagnostic Point:

Unspecified mononeuropathy of the right upper limb refers to a condition characterized by damage or dysfunction of a single peripheral nerve in the right arm, leading to symptoms such as pain, weakness, numbness, or tingling. This condition can arise from various causes, including trauma, repetitive motion injuries, or systemic diseases like diabetes. The term 'unspecified' indicates that the exact nerve affected is not documented, which can complicate diagnosis and treatment. Commonly affected nerves in the upper limb include the median, ulnar, and radial nerves. Clinicians often rely on nerve conduction studies (NCS) and electromyography (EMG) to assess nerve function and identify the underlying cause of the neuropathy. Treatment may involve physical therapy, medications for pain management, or surgical intervention if there is significant nerve compression. Accurate coding is essential for proper reimbursement and to reflect the patient's condition in medical records.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Lack of specificity in documentation regarding the affected nerve
  • Variability in clinical presentation and symptoms
  • Need for correlation with diagnostic tests like NCS and EMG
  • Potential overlap with other neuropathic conditions

Audit Risk Factors

  • Insufficient documentation of symptoms and clinical findings
  • Failure to perform or document nerve conduction studies
  • Inconsistent coding of related conditions
  • Lack of follow-up documentation to support ongoing treatment

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, results of NCS/EMG, and treatment plans.

Common Clinical Scenarios

Patients presenting with numbness, tingling, or weakness in the right upper limb.

Billing Considerations

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

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, treatment goals, and progress notes.

Common Clinical Scenarios

Rehabilitation following nerve injury or surgery.

Billing Considerations

Document the impact of the condition on daily activities and rehabilitation progress.

Coding Guidelines

Inclusion Criteria

Use G56.91 When
  • According to ICD
  • 10 coding guidelines, G56
  • 91 should be used when the specific nerve affected is not documented
  • Coders should ensure that the documentation supports the diagnosis and that other potential causes of neuropathy are ruled out

Exclusion Criteria

Do NOT use G56.91 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95900CPT Code

Nerve conduction studies

Clinical Scenario

Used to evaluate nerve function in patients with suspected mononeuropathy.

Documentation Requirements

Document the rationale for the study and findings.

Specialty Considerations

Neurologists should ensure comprehensive documentation of symptoms and 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 accuracy of diagnoses and treatment plans. G56.91 reflects the need for precise documentation to avoid ambiguity in patient care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neuropathies, improving the accuracy of diagnoses and treatment plans. G56.91 reflects the need for precise documentation to avoid ambiguity in patient care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of neuropathies, improving the accuracy of diagnoses and treatment plans. G56.91 reflects the need for precise documentation to avoid ambiguity in patient care.

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 should I document to support the use of G56.91?

Document the patient's symptoms, clinical findings, results of any nerve conduction studies, and the rationale for the diagnosis. Ensure that the documentation is clear and comprehensive to support the use of this code.