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ICD-10 Guide
ICD-10 CodesG57.72

G57.72

Billable

Causalgia of left lower limb

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

Code Description

ICD-10 G57.72 is a billable code used to indicate a diagnosis of causalgia of left lower limb.

Key Diagnostic Point:

Causalgia, also known as complex regional pain syndrome (CRPS), is a chronic pain condition that typically follows an injury or trauma to a limb. In the case of G57.72, the condition specifically affects the left lower limb. Patients often experience severe burning pain, swelling, and changes in skin color and temperature. The pain is disproportionate to the initial injury and may be accompanied by sensory abnormalities, such as hyperesthesia or allodynia. The pathophysiology of causalgia involves dysregulation of the sympathetic nervous system and abnormal inflammatory responses. Diagnosis is primarily clinical, supported by patient history and physical examination, and may include nerve conduction studies to assess nerve function and rule out other neuropathies. Treatment often involves a multidisciplinary approach, including pain management, physical therapy, and psychological support. Accurate coding is crucial for appropriate reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of complex regional pain syndrome and its manifestations.
  • Differentiation from other neuropathic pain conditions.
  • Need for comprehensive documentation to support the diagnosis.
  • Potential for co-morbid conditions that may complicate coding.

Audit Risk Factors

  • Inadequate documentation of the severity and duration of symptoms.
  • Failure to document prior treatments and their outcomes.
  • Misclassification of causalgia as a different neuropathic pain syndrome.
  • Lack of supporting diagnostic tests in the medical record.

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 trauma, with neurological deficits.

Billing Considerations

Documentation should include the patient's pain scale, functional limitations, and response to treatments.

Pain Management

Documentation Requirements

Comprehensive pain assessments, treatment plans, and response to interventions.

Common Clinical Scenarios

Management of chronic pain syndromes, including pharmacological and non-pharmacological therapies.

Billing Considerations

Documentation must reflect the multidisciplinary approach to treatment and any referrals made.

Coding Guidelines

Inclusion Criteria

Use G57.72 When
  • According to ICD
  • 10 guidelines, G57
  • 72 should be used when the clinical documentation supports a diagnosis of causalgia specifically affecting the left lower limb
  • It is important to ensure that the diagnosis is not confused with other neuropathic pain syndromes, which may have different codes

Exclusion Criteria

Do NOT use G57.72 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95903CPT Code

Nerve conduction study, motor and sensory

Clinical Scenario

Used to evaluate nerve function in patients with suspected causalgia.

Documentation Requirements

Document the rationale for the study and findings.

Specialty Considerations

Neurologists should ensure comprehensive reports that 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 conditions like causalgia, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better understanding patient populations and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like causalgia, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better understanding patient populations and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like causalgia, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better understanding patient populations and outcomes.

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 is the primary cause of causalgia?

Causalgia is often triggered by an injury or trauma to a limb, leading to abnormal pain signaling and sympathetic nervous system dysregulation.