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v1.0.0
ICD-10 Guide
ICD-10 CodesG54.7

G54.7

Billable

Phantom limb syndrome without pain

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

Code Description

ICD-10 G54.7 is a billable code used to indicate a diagnosis of phantom limb syndrome without pain.

Key Diagnostic Point:

Phantom limb syndrome without pain is a neurological condition that occurs in individuals who have undergone amputation of a limb. Patients may experience sensations that the missing limb is still present, which can include feelings of warmth, coldness, itchiness, or tingling. Unlike phantom limb pain, which is characterized by painful sensations in the absent limb, phantom limb syndrome without pain does not involve discomfort. The underlying mechanism is believed to be related to the brain's representation of the body, where the neural pathways associated with the missing limb remain active despite its physical absence. This condition can be associated with various cranial nerve disorders, nerve entrapments, and neuropathies, as the brain continues to process sensory information related to the missing limb. Diagnosis typically involves a thorough clinical evaluation, including patient history and neurological examination, to differentiate it from other neuropathic conditions. Understanding the patient's experience and providing appropriate psychological support is crucial for managing this syndrome effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from phantom limb pain
  • Need for comprehensive patient history
  • Potential overlap with other neuropathic conditions
  • Documentation of sensory experiences

Audit Risk Factors

  • Inadequate documentation of sensory experiences
  • Misclassification with phantom limb pain
  • Failure to document the amputation history
  • Lack of neurological examination details

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, patient history of amputation, and sensory descriptions.

Common Clinical Scenarios

Patients presenting with sensations in a missing limb post-amputation.

Billing Considerations

Ensure clear documentation to differentiate from other neuropathic conditions.

Pain Management

Documentation Requirements

Assessment of pain levels, psychological evaluation, and treatment plans.

Common Clinical Scenarios

Management of patients with phantom limb sensations seeking pain relief.

Billing Considerations

Document any psychological support provided to the patient.

Coding Guidelines

Inclusion Criteria

Use G54.7 When
  • According to ICD
  • 10 guidelines, G54
  • 7 should be used when the patient experiences phantom limb sensations without pain
  • It is essential to document the absence of pain clearly to avoid misclassification

Exclusion Criteria

Do NOT use G54.7 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95900CPT Code

Nerve conduction studies

Clinical Scenario

Used to evaluate nerve function in patients with neuropathic symptoms.

Documentation Requirements

Document the rationale for nerve conduction studies and the patient's symptoms.

Specialty Considerations

Neurologists should ensure that the studies are relevant to the patient's condition.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like phantom limb syndrome, improving the accuracy of diagnoses and treatment plans.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like phantom limb syndrome, improving the accuracy of diagnoses and treatment plans.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like phantom limb syndrome, improving the accuracy of diagnoses and treatment plans.

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 difference between phantom limb syndrome and phantom limb pain?

Phantom limb syndrome refers to the sensation of the missing limb without pain, while phantom limb pain involves painful sensations in the absent limb. Accurate documentation is crucial to differentiate between the two for proper coding.