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ICD-10 Guide
ICD-10 CodesB33.3

B33.3

Postherpetic polyneuropathy

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

Code Description

ICD-10 B33.3 is a billable code used to indicate a diagnosis of postherpetic polyneuropathy.

Key Diagnostic Point:

Postherpetic polyneuropathy is a complication that arises following an outbreak of herpes zoster (shingles), which is caused by the reactivation of the varicella-zoster virus (VZV). This condition is characterized by persistent neuropathic pain and sensory disturbances that can occur in the area previously affected by the herpes zoster rash. The pain can be debilitating and may last for months or even years after the initial infection has resolved. Patients often report symptoms such as burning, tingling, and allodynia, where normally non-painful stimuli cause pain. Diagnosis is primarily clinical, based on the patient's history of shingles and the presence of neuropathic pain. Diagnostic methods may include nerve conduction studies and electromyography to assess the extent of nerve damage. Antiviral treatments, such as acyclovir, valacyclovir, or famciclovir, are most effective when administered early in the course of herpes zoster. However, their efficacy in preventing postherpetic polyneuropathy is limited. Management of postherpetic pain may involve analgesics, anticonvulsants, or antidepressants, which can help alleviate symptoms and improve quality of life.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires knowledge of herpes zoster and its complications.
  • Differentiation from other neuropathic pain conditions.
  • Documentation of prior herpes zoster infection is essential.
  • Potential for overlapping symptoms with other neuropathies.

Audit Risk Factors

  • Inadequate documentation of prior herpes zoster infection.
  • Misdiagnosis or coding of similar neuropathic conditions.
  • Failure to document the severity and duration of symptoms.
  • Inconsistent use of pain management codes.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed history of neurological symptoms, prior herpes zoster infection, and results from nerve conduction studies.

Common Clinical Scenarios

Patients presenting with chronic pain following shingles, requiring assessment for neuropathic pain management.

Billing Considerations

Neurologists should ensure comprehensive documentation of symptomatology and treatment response.

Pain Management

Documentation Requirements

Thorough documentation of pain characteristics, treatment history, and response to therapies.

Common Clinical Scenarios

Management of chronic pain in patients with a history of herpes zoster.

Billing Considerations

Pain management specialists should document the multidisciplinary approach to treatment.

Coding Guidelines

Inclusion Criteria

Use B33.3 When
  • According to ICD
  • 10 guidelines, B33
  • 3 should be used when there is a clear link between a prior herpes zoster infection and the development of polyneuropathy
  • Documentation must support the diagnosis, including the history of shingles and current symptoms

Exclusion Criteria

Do NOT use B33.3 When
No specific exclusions found.

Related CPT Codes

64400CPT Code

Injection, anesthetic agent into a major nerve or nerve plexus

Clinical Scenario

Used for pain management in patients with postherpetic polyneuropathy.

Documentation Requirements

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

Specialty Considerations

Pain management specialists should ensure that the injection is justified based on 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 postherpetic polyneuropathy, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of detailed documentation and differentiation from other neuropathic conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of postherpetic polyneuropathy, improving the accuracy of data collection and reimbursement processes. It emphasizes the importance of detailed documentation and differentiation from other neuropathic conditions.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the importance of detailed documentation and differentiation from other neuropathic conditions.

Resources

Clinical References

  • •
    CDC - Shingles (Herpes Zoster)

Coding & Billing References

  • •
    CDC - Shingles (Herpes Zoster)

Frequently Asked Questions

What is the primary cause of postherpetic polyneuropathy?

Postherpetic polyneuropathy is primarily caused by the reactivation of the varicella-zoster virus, which leads to nerve damage and persistent pain following a shingles outbreak.