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ICD-10 Guide
ICD-10 CodesG56.13

G56.13

Billable

Other lesions of median nerve, bilateral upper limbs

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

Code Description

ICD-10 G56.13 is a billable code used to indicate a diagnosis of other lesions of median nerve, bilateral upper limbs.

Key Diagnostic Point:

G56.13 refers to other lesions affecting the median nerve in both upper limbs. The median nerve is crucial for motor and sensory functions in the hand, and lesions can result from various conditions, including trauma, compression, or systemic diseases. Common presentations include pain, numbness, and weakness in the hand, particularly affecting the thumb, index, and middle fingers. Conditions such as carpal tunnel syndrome, which is a common entrapment neuropathy, may lead to these lesions. Diagnosis often involves clinical evaluation, nerve conduction studies, and imaging to assess the extent of nerve damage. Treatment may include conservative management such as splinting and physical therapy, or surgical intervention in severe cases. 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 clinical presentation and underlying causes
  • Need for comprehensive documentation of symptoms and diagnostic tests
  • Potential overlap with other neuropathies and nerve entrapments
  • Requirement for detailed history and physical examination findings

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to specify bilateral involvement
  • Misclassification of the type of nerve lesion
  • Lack of supporting diagnostic tests in the medical record

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, including sensory and motor assessments.

Common Clinical Scenarios

Patients presenting with bilateral hand numbness and weakness, requiring nerve conduction studies.

Billing Considerations

Ensure documentation reflects the bilateral nature of the condition and any relevant comorbidities.

Orthopedics

Documentation Requirements

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

Common Clinical Scenarios

Patients with median nerve lesions requiring surgical intervention for decompression.

Billing Considerations

Document the surgical approach and any intraoperative findings that may affect coding.

Coding Guidelines

Inclusion Criteria

Use G56.13 When
  • Follow official ICD
  • CM guidelines for coding nerve disorders, ensuring accurate documentation of the lesion type and bilateral involvement
  • Include any relevant diagnostic tests and clinical findings

Exclusion Criteria

Do NOT use G56.13 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95903CPT Code

Nerve conduction study, each nerve

Clinical Scenario

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

Documentation Requirements

Document the specific nerves tested and the results of the study.

Specialty Considerations

Neurologists should ensure comprehensive documentation of findings to support the diagnosis.

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. G56.13 provides a distinct code for bilateral median nerve lesions, enhancing the granularity of data for clinical and billing purposes.

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. G56.13 provides a distinct code for bilateral median nerve lesions, enhancing the granularity of data for clinical and billing purposes.

Reimbursement & Billing Impact

billing purposes.

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 variations that lead to nerve compression.

How can I differentiate between G56.13 and G56.00?

G56.13 is used for other lesions of the median nerve, while G56.00 specifically refers to carpal tunnel syndrome. Documentation should clarify the specific diagnosis.