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ICD-10 Guide
ICD-10 CodesG57.7

G57.7

Billable

Causalgia of lower limb

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

Code Description

ICD-10 G57.7 is a billable code used to indicate a diagnosis of causalgia of lower limb.

Key Diagnostic Point:

Causalgia of the lower limb is a chronic pain condition characterized by severe burning pain, typically following an injury to a peripheral nerve. This condition is often associated with dysesthesia, allodynia, and hyperalgesia in the affected area. The pain may be accompanied by changes in skin color, temperature, and sweating, reflecting the underlying sympathetic nervous system involvement. Causalgia can arise from various causes, including trauma, surgery, or nerve entrapment syndromes. Diagnosis is primarily clinical, supported by patient history and physical examination, and may involve nerve conduction studies to assess the integrity and function of the affected nerves. Treatment options include pharmacological management with analgesics, anticonvulsants, and nerve blocks, as well as physical therapy and psychological support. The complexity of causalgia lies in its multifactorial nature and the need for a comprehensive approach to management, which may involve multiple specialties.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Multifactorial etiology requiring thorough patient history and examination.
  • Potential overlap with other neuropathic pain conditions.
  • Need for specialized diagnostic tests like nerve conduction studies.
  • Variability in treatment approaches across specialties.

Audit Risk Factors

  • Inadequate documentation of pain severity and functional limitations.
  • Failure to document the specific nerve involved.
  • Lack of evidence for conservative treatment attempts before advanced interventions.
  • Misclassification of causalgia as a simple neuropathy.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, including sensory and motor assessments.

Common Clinical Scenarios

Patients presenting with chronic pain following a lower limb injury or surgery.

Billing Considerations

Documentation should include the impact of symptoms on daily activities and any previous treatments attempted.

Pain Management

Documentation Requirements

Comprehensive pain assessments, including pain scales and functional assessments.

Common Clinical Scenarios

Management of chronic pain syndromes with a focus on multimodal treatment strategies.

Billing Considerations

Documentation must reflect the interdisciplinary approach and any referrals to physical therapy or psychological support.

Coding Guidelines

Inclusion Criteria

Use G57.7 When
  • According to ICD
  • 10 guidelines, G57
  • 7 should be used when the clinical documentation supports a diagnosis of causalgia specifically affecting the lower limb
  • It is important to ensure that the documentation clearly indicates the chronic nature of the pain and any associated symptoms

Exclusion Criteria

Do NOT use G57.7 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95903CPT Code

Nerve conduction study, upper limb

Clinical Scenario

Used to assess nerve function in patients with suspected causalgia.

Documentation Requirements

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

Specialty Considerations

Neurologists should ensure that the study correlates 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 causalgia, improving the ability to capture the complexity of the condition and its management. This specificity aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of causalgia, improving the ability to capture the complexity of the condition and its management. This specificity aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of causalgia, improving the ability to capture the complexity of the condition and its management. This specificity aids in better tracking of treatment outcomes and resource allocation.

Resources

Clinical References

  • •
    American Academy of Neurology

Coding & Billing References

  • •
    American Academy of Neurology

Frequently Asked Questions

What is the primary treatment for causalgia?

The primary treatment for causalgia includes a combination of pharmacological therapies such as analgesics and anticonvulsants, along with physical therapy and possibly nerve blocks. A multidisciplinary approach is often necessary for effective management.