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v1.0.0
ICD-10 Guide
ICD-10 CodesG56.11

G56.11

Billable

Other lesions of median nerve, right upper limb

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

Code Description

ICD-10 G56.11 is a billable code used to indicate a diagnosis of other lesions of median nerve, right upper limb.

Key Diagnostic Point:

G56.11 refers to lesions affecting the median nerve in the right upper limb, which can result from various conditions such as trauma, compression, or systemic diseases. The median nerve is crucial for motor and sensory functions in the hand, particularly in the thumb, index, middle fingers, and part of the ring finger. Lesions can lead to symptoms such as pain, numbness, tingling, and weakness in the affected areas. Common causes include carpal tunnel syndrome, which is a form of nerve entrapment, as well as other neuropathies that may arise from diabetes or other systemic conditions. Diagnosis often involves clinical examination, nerve conduction studies, and imaging techniques to assess the extent and nature of the lesion. Treatment may include conservative measures such as splinting, corticosteroid injections, or surgical intervention depending on the severity and underlying cause of the lesion.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes (e.g., trauma, systemic diseases)
  • Differentiation from other neuropathies and nerve entrapments
  • Need for precise documentation of symptoms and clinical findings
  • Potential for co-morbid conditions affecting the median nerve

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to specify the exact nature of the lesion
  • Misclassification of the lesion type
  • Inconsistent coding with 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, tingling, or weakness in the hand.

Billing Considerations

Ensure documentation reflects the specific nature of the lesion and any diagnostic tests performed.

Orthopedics

Documentation Requirements

Surgical notes, imaging results, and pre-operative assessments.

Common Clinical Scenarios

Patients undergoing surgical intervention for median nerve decompression.

Billing Considerations

Document the surgical approach and any intraoperative findings related to the median nerve.

Coding Guidelines

Inclusion Criteria

Use G56.11 When
  • According to ICD
  • 10 guidelines, G56
  • 11 should be used when the lesion is specifically identified as affecting the median nerve in the right upper limb
  • Coders should ensure that the documentation supports the diagnosis and that any relevant tests or imaging are included

Exclusion Criteria

Do NOT use G56.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

64721CPT Code

Neuroplasty, median nerve

Clinical Scenario

Used when surgical intervention is performed to relieve median nerve compression.

Documentation Requirements

Surgical notes detailing the procedure and findings.

Specialty Considerations

Orthopedic documentation should include pre-operative assessments and post-operative care plans.

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. G56.11 provides a clear designation for lesions of the median nerve, facilitating better tracking of patient outcomes and resource allocation.

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. G56.11 provides a clear designation for lesions of the median nerve, facilitating better tracking of patient outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of nerve lesions, improving the accuracy of diagnoses and treatment plans. G56.11 provides a clear designation for lesions of the median nerve, facilitating better tracking of patient outcomes and resource allocation.

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 trauma, repetitive strain injuries, systemic diseases like diabetes, and compression syndromes such as carpal tunnel syndrome.

How do I differentiate between G56.11 and G56.00?

G56.11 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.