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ICD-10 Guide
ICD-10 CodesG54.5

G54.5

Billable

Neuralgic amyotrophy

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

Code Description

ICD-10 G54.5 is a billable code used to indicate a diagnosis of neuralgic amyotrophy.

Key Diagnostic Point:

Neuralgic amyotrophy, also known as Parsonage-Turner syndrome, is a neurological condition characterized by sudden onset of shoulder pain followed by weakness and atrophy of the shoulder and arm muscles. The condition is believed to result from inflammation of the brachial plexus, a network of nerves that sends signals from the spine to the shoulder, arm, and hand. Patients typically experience severe pain in the shoulder region, which may be unilateral, followed by muscle weakness that can affect the deltoid, supraspinatus, and infraspinatus muscles. The exact etiology remains unclear, but it may be associated with viral infections, trauma, or autoimmune responses. Diagnosis is primarily clinical, supported by electromyography (EMG) and nerve conduction studies (NCS) to assess nerve function and rule out other neuropathies. Recovery can take weeks to months, and while some patients may regain full function, others may experience persistent weakness or pain.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity among patients
  • Overlap with other neuropathies and cranial nerve disorders
  • Need for comprehensive documentation of symptoms and diagnostic tests
  • Potential for misdiagnosis due to similar presentations with other conditions

Audit Risk Factors

  • Inadequate documentation of the acute pain phase
  • Failure to document the results of nerve conduction studies
  • Misclassification of the condition as a different neuropathy
  • Lack of follow-up documentation on recovery progress

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed clinical notes on symptom onset, pain characteristics, and neurological examination findings.

Common Clinical Scenarios

Patients presenting with acute shoulder pain and subsequent weakness in the arm.

Billing Considerations

Ensure that nerve conduction studies and EMG results are clearly documented to support the diagnosis.

Physical Medicine and Rehabilitation

Documentation Requirements

Rehabilitation progress notes, including functional assessments and treatment plans.

Common Clinical Scenarios

Patients undergoing rehabilitation for muscle weakness following neuralgic amyotrophy.

Billing Considerations

Document the patient's functional limitations and response to therapy to justify ongoing treatment.

Coding Guidelines

Inclusion Criteria

Use G54.5 When
  • According to ICD
  • 10 guidelines, G54
  • 5 should be used when there is clear documentation of neuralgic amyotrophy
  • It is essential to include the patient's clinical history, symptomatology, and results from diagnostic tests like EMG and NCS

Exclusion Criteria

Do NOT use G54.5 When
  • Exclusion criteria include other specific neuropathies that may present similarly

Related ICD-10 Codes

Related CPT Codes

95860CPT Code

Electromyography (EMG)

Clinical Scenario

Used to confirm diagnosis of neuralgic amyotrophy.

Documentation Requirements

Results of the EMG must be documented, including findings of denervation.

Specialty Considerations

Neurologists should ensure that the EMG findings correlate with clinical symptoms.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of neuralgic amyotrophy, improving the accuracy of diagnosis and treatment tracking. It has also facilitated better data collection for research and epidemiological studies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neuralgic amyotrophy, improving the accuracy of diagnosis and treatment tracking. It has also facilitated better data collection for research and epidemiological studies.

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 are the common symptoms of neuralgic amyotrophy?

Common symptoms include sudden shoulder pain, followed by weakness and atrophy of the shoulder and arm muscles. Patients may also experience sensory changes in the affected area.