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ICD-10 Guide
ICD-10 CodesG57.91

G57.91

Billable

Unspecified mononeuropathy of right lower limb

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

Code Description

ICD-10 G57.91 is a billable code used to indicate a diagnosis of unspecified mononeuropathy of right lower limb.

Key Diagnostic Point:

Unspecified mononeuropathy of the right lower limb refers to a condition characterized by damage or dysfunction of a single peripheral nerve in the right leg, leading to symptoms such as pain, weakness, numbness, or tingling. This condition can arise from various causes, including trauma, compression, or systemic diseases. Common examples include entrapment syndromes like peroneal nerve palsy or tarsal tunnel syndrome. Diagnosis typically involves a thorough clinical evaluation, including a detailed history and physical examination, followed by nerve conduction studies (NCS) to assess the electrical activity of the affected nerve. The unspecified nature of this code indicates that the specific nerve involved has not been identified, which can complicate treatment and management strategies. Clinicians must consider differential diagnoses, including other neuropathies or radiculopathies, to ensure appropriate care. Treatment may involve physical therapy, medications for pain relief, or surgical intervention if necessary. 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

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

Audit Risk Factors

  • Insufficient documentation of symptoms
  • Lack of detailed history regarding onset and duration
  • Failure to perform or document nerve conduction studies
  • Inadequate differentiation from other neuropathies

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, results of nerve conduction studies, and a clear treatment plan.

Common Clinical Scenarios

Patients presenting with unilateral leg weakness, numbness, or pain without a clear diagnosis.

Billing Considerations

Ensure that all relevant diagnostic tests are documented to support the use of unspecified codes.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, treatment goals, and progress notes detailing rehabilitation efforts.

Common Clinical Scenarios

Patients undergoing rehabilitation for nerve injuries or neuropathies.

Billing Considerations

Documenting the impact of the condition on daily activities and functional outcomes is crucial.

Coding Guidelines

Inclusion Criteria

Use G57.91 When
  • According to the ICD
  • CM coding guidelines, this code should be used when the specific nerve affected is not documented
  • Coders should ensure that the documentation supports the diagnosis and that all relevant clinical information is included

Exclusion Criteria

Do NOT use G57.91 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95903CPT Code

Nerve conduction study, each nerve

Clinical Scenario

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

Documentation Requirements

Document the specific nerves tested and the results of the study.

Specialty Considerations

Neurologists should ensure that the rationale for the study is clearly documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more detailed coding of neuropathies, including the ability to specify laterality. G57.91 reflects the need for coders to be diligent in documenting the specifics of the condition to ensure accurate coding and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more detailed coding of neuropathies, including the ability to specify laterality. G57.91 reflects the need for coders to be diligent in documenting the specifics of the condition to ensure accurate coding and reimbursement.

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 should I document to support the use of G57.91?

To support the use of G57.91, document the patient's symptoms, clinical findings, results of any nerve conduction studies, and the rationale for not specifying the affected nerve.