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ICD-10 Guide
ICD-10 CodesG90.512

G90.512

Billable

Complex regional pain syndrome I of left upper limb

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

Code Description

ICD-10 G90.512 is a billable code used to indicate a diagnosis of complex regional pain syndrome i of left upper limb.

Key Diagnostic Point:

Complex Regional Pain Syndrome (CRPS) I, previously known as Reflex Sympathetic Dystrophy (RSD), is a chronic pain condition that typically affects a limb following an injury or trauma. CRPS I is characterized by severe, persistent pain that is disproportionate to the initial injury. The pain is often accompanied by sensory, motor, and autonomic dysfunctions. In the case of G90.512, the syndrome specifically affects the left upper limb. Patients may experience symptoms such as swelling, changes in skin color and temperature, and abnormal sweating patterns. The pathophysiology of CRPS involves a complex interplay of peripheral and central nervous system mechanisms, leading to heightened pain perception and altered pain processing. Diagnosis is primarily clinical, based on patient history and symptomatology, and may be supported by imaging studies or nerve conduction tests. Early recognition and intervention are crucial to improve outcomes and reduce the risk of long-term disability.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Varied presentation of symptoms among patients
  • Need for comprehensive documentation of pain characteristics
  • Potential overlap with other pain syndromes
  • Requirement for multidisciplinary approach in management

Audit Risk Factors

  • Inadequate documentation of pain severity and duration
  • Failure to document the specific limb affected
  • Lack of evidence for the initial injury or trauma
  • Inconsistent coding of associated symptoms

Specialty Focus

Medical Specialties

Pain Management

Documentation Requirements

Detailed pain assessments, treatment plans, and response to therapies.

Common Clinical Scenarios

Patients presenting with chronic pain following trauma or surgery.

Billing Considerations

Documentation should include a comprehensive pain history and any psychological assessments.

Neurology

Documentation Requirements

Neurological examinations, imaging results, and differential diagnoses.

Common Clinical Scenarios

Patients with neuropathic pain and autonomic dysfunction.

Billing Considerations

Consideration of other neurological disorders that may mimic CRPS symptoms.

Coding Guidelines

Inclusion Criteria

Use G90.512 When
  • According to ICD
  • 10 guidelines, G90
  • 512 should be used when the patient has a confirmed diagnosis of CRPS I affecting the left upper limb
  • Documentation must clearly indicate the affected limb and the nature of the pain

Exclusion Criteria

Do NOT use G90.512 When
  • Exclusion criteria include other specified pain syndromes that do not meet the diagnostic criteria for CRPS

Related ICD-10 Codes

Related CPT Codes

64450CPT Code

Injection, anesthetic agent into a major nerve

Clinical Scenario

Used for pain management in CRPS patients.

Documentation Requirements

Document the specific nerve targeted and the patient's response to the injection.

Specialty Considerations

Pain management specialists should ensure thorough documentation of the patient's pain history.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of CRPS, improving the accuracy of data collection and reimbursement processes. G90.512 provides a clear distinction for CRPS I affecting the left upper limb, which aids in clinical management and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of CRPS, improving the accuracy of data collection and reimbursement processes. G90.512 provides a clear distinction for CRPS I affecting the left upper limb, which aids in clinical management and research.

Reimbursement & Billing Impact

reimbursement processes. G90.512 provides a clear distinction for CRPS I affecting the left upper limb, which aids in clinical management and research.

Resources

Clinical References

  • •
    American Academy of Pain Medicine

Coding & Billing References

  • •
    American Academy of Pain Medicine

Frequently Asked Questions

What are the primary symptoms of CRPS I?

Primary symptoms include severe pain, swelling, changes in skin color and temperature, and abnormal sweating in the affected limb.

How is CRPS I diagnosed?

Diagnosis is primarily clinical, based on patient history and symptomatology, often supported by imaging studies or nerve conduction tests.