Carpal tunnel syndrome, right upper limb
ICD-10 G56.01 is a billable code used to indicate a diagnosis of carpal tunnel syndrome, right upper limb.
Carpal tunnel syndrome (CTS) is a common condition that arises from the compression of the median nerve as it travels through the carpal tunnel in the wrist. This syndrome is characterized by symptoms such as numbness, tingling, and weakness in the hand, particularly affecting the thumb, index, middle, and part of the ring finger. The condition is often associated with repetitive wrist movements, certain medical conditions (like diabetes and hypothyroidism), and can be exacerbated by pregnancy. Diagnosis typically involves a thorough clinical examination, patient history, and may include nerve conduction studies (NCS) to assess the function of the median nerve. NCS can help confirm the diagnosis by measuring the speed of nerve impulses and identifying any delays indicative of compression. Treatment options range from conservative management, such as splinting and corticosteroid injections, to surgical intervention in more severe cases. Understanding the nuances of CTS is crucial for accurate coding and appropriate management.
Detailed neurological examination findings, results of nerve conduction studies, and treatment plans.
Patients presenting with numbness and tingling in the hand, especially those with a history of repetitive wrist use.
Ensure documentation reflects the severity of symptoms and any impact on daily activities.
Surgical notes if surgery is performed, pre-operative assessments, and post-operative follow-up.
Patients requiring surgical intervention for severe carpal tunnel syndrome.
Document the rationale for surgical intervention and any pre-existing conditions that may affect recovery.
Used when surgical intervention is required for severe carpal tunnel syndrome.
Surgical notes, pre-operative assessments, and post-operative follow-up documentation.
Orthopedic documentation should include details of the surgical procedure and any complications.
Common symptoms include numbness, tingling, and weakness in the hand, particularly affecting the thumb, index, and middle fingers. Symptoms may worsen at night or with repetitive wrist movements.
