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ICD-10 Guide
ICD-10 CodesG56.10

G56.10

Billable

Other lesions of median nerve, unspecified upper limb

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

Code Description

ICD-10 G56.10 is a billable code used to indicate a diagnosis of other lesions of median nerve, unspecified upper limb.

Key Diagnostic Point:

G56.10 refers to lesions of the median nerve that are not classified elsewhere and occur in the unspecified upper limb. The median nerve is crucial for sensory and motor functions in the hand, particularly in the thumb, index, middle, and part of the ring finger. Lesions can arise from various causes, including trauma, compression, or systemic diseases affecting nerve integrity. Symptoms may include pain, numbness, tingling, and weakness in the affected areas. Diagnosis often involves clinical evaluation, nerve conduction studies, and imaging to assess the extent of the lesion and its impact on nerve function. Treatment may vary from conservative management, such as splinting and physical therapy, to surgical intervention in cases of severe compression or injury. Accurate coding is essential for proper reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in presentation and symptoms of median nerve lesions
  • Need for comprehensive documentation to support the diagnosis
  • Differentiation from other neuropathies and nerve entrapments
  • Potential for multiple underlying causes requiring thorough investigation

Audit Risk Factors

  • Insufficient documentation of symptoms and clinical findings
  • Failure to specify the location of the lesion
  • Inadequate justification for the use of this code over more specific codes
  • Lack of correlation between diagnosis and treatment provided

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, including sensory and motor assessments.

Common Clinical Scenarios

Patients presenting with numbness and tingling in the hand, often after repetitive use or trauma.

Billing Considerations

Documentation should clearly outline the clinical rationale for the diagnosis and any diagnostic tests performed.

Orthopedics

Documentation Requirements

Surgical notes and pre-operative assessments detailing the extent of nerve involvement.

Common Clinical Scenarios

Patients with median nerve compression due to anatomical abnormalities or trauma requiring surgical intervention.

Billing Considerations

Ensure that the surgical procedure aligns with the diagnosis and that all relevant findings are documented.

Coding Guidelines

Inclusion Criteria

Use G56.10 When
  • According to ICD
  • 10 guidelines, G56
  • 10 should be used when the specific cause of the median nerve lesion is not documented
  • Coders should ensure that the documentation supports the diagnosis and that any relevant tests, such as nerve conduction studies, are included

Exclusion Criteria

Do NOT use G56.10 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95903CPT Code

Nerve conduction study, motor and sensory

Clinical Scenario

Used to evaluate the function of the median nerve in patients with suspected lesions.

Documentation Requirements

Results of the nerve conduction study must be documented, including latencies and amplitudes.

Specialty Considerations

Neurologists should ensure that the study correlates with clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of nerve lesions, improving the accuracy of diagnoses and treatment plans. G56.10 provides a means to capture cases that do not fit neatly into other categories, ensuring that patients receive appropriate care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of nerve lesions, improving the accuracy of diagnoses and treatment plans. G56.10 provides a means to capture cases that do not fit neatly into other categories, ensuring that patients receive appropriate care.

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 causes of median nerve lesions?

Common causes include repetitive strain injuries, trauma, systemic diseases like diabetes, and anatomical abnormalities that compress the nerve.

How can I differentiate between G56.10 and G56.00?

G56.10 is used for unspecified lesions of the median nerve, while G56.00 specifically refers to carpal tunnel syndrome. Documentation should clarify the nature of the lesion.