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ICD-10 Guide
ICD-10 CodesM21.33

M21.33

Billable

Wrist drop (acquired)

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/17/2025

Code Description

ICD-10 M21.33 is a billable code used to indicate a diagnosis of wrist drop (acquired).

Key Diagnostic Point:

Wrist drop, also known as radial nerve palsy, is a condition characterized by the inability to extend the wrist and fingers due to weakness or paralysis of the extensor muscles. This acquired deformity typically results from trauma, compression, or injury to the radial nerve, which can occur from various causes such as fractures of the humerus, prolonged pressure on the nerve (e.g., from crutches), or systemic diseases like diabetes. Patients with wrist drop may present with a characteristic 'wrist drop' posture, where the wrist is flexed and the fingers are unable to extend, leading to functional impairment in hand use. The condition can significantly affect daily activities, including grasping objects and performing fine motor tasks. Treatment often involves physical therapy, splinting, and in some cases, surgical intervention to relieve nerve compression or repair nerve damage. Understanding the underlying cause of the wrist drop is crucial for effective management and rehabilitation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between acquired and congenital causes
  • Identifying the specific underlying condition causing the wrist drop
  • Documenting associated conditions or injuries
  • Understanding the impact of comorbidities on treatment and coding

Audit Risk Factors

  • Inadequate documentation of the cause of wrist drop
  • Failure to document associated conditions or injuries
  • Incorrect coding of the severity or type of nerve injury
  • Lack of clarity in treatment plans and outcomes

Specialty Focus

Medical Specialties

Orthopedics

Documentation Requirements

Detailed notes on the mechanism of injury, physical examination findings, and treatment plans.

Common Clinical Scenarios

Patients presenting with wrist drop following humeral fractures or after prolonged pressure on the radial nerve.

Billing Considerations

Ensure to document any surgical interventions or physical therapy referrals.

Neurology

Documentation Requirements

Comprehensive neurological assessments, including motor function tests and nerve conduction studies.

Common Clinical Scenarios

Patients with wrist drop due to systemic conditions like diabetes or multiple sclerosis.

Billing Considerations

Document any neurological evaluations and the patient's response to treatment.

Coding Guidelines

Inclusion Criteria

Use M21.33 When
  • According to ICD
  • 10 guidelines, M21
  • 33 should be used when the wrist drop is acquired, and the underlying cause must be documented

Exclusion Criteria

Do NOT use M21.33 When
  • Exclusion criteria include congenital causes or conditions that do not directly result in wrist drop

Related ICD-10 Codes

Related CPT Codes

64721CPT Code

Neuroplasty, radial nerve

Clinical Scenario

Used when surgical intervention is required for nerve repair.

Documentation Requirements

Surgical notes detailing the procedure and indications.

Specialty Considerations

Orthopedic or neurosurgical documentation should clearly outline the rationale for surgery.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of wrist drop, improving the ability to capture the nuances of acquired conditions and their underlying causes, which enhances data accuracy and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of wrist drop, improving the ability to capture the nuances of acquired conditions and their underlying causes, which enhances data accuracy and treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of wrist drop, improving the ability to capture the nuances of acquired conditions and their underlying causes, which enhances data accuracy and treatment planning.

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 wrist drop?

Wrist drop is primarily caused by injury or compression of the radial nerve, which can occur due to trauma, prolonged pressure, or systemic diseases.