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ICD-10 Guide
ICD-10 CodesG57.42

G57.42

Billable

Lesion of medial popliteal nerve, left lower limb

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

Code Description

ICD-10 G57.42 is a billable code used to indicate a diagnosis of lesion of medial popliteal nerve, left lower limb.

Key Diagnostic Point:

The medial popliteal nerve, a branch of the sciatic nerve, innervates the muscles of the posterior compartment of the leg and provides sensation to the skin of the posterior aspect of the leg and the plantar aspect of the foot. A lesion of this nerve can result from various causes, including trauma, compression, or systemic diseases such as diabetes mellitus. Clinically, patients may present with symptoms such as weakness in plantar flexion, loss of sensation in the affected areas, and pain or paresthesia along the nerve's distribution. Diagnosis typically involves a thorough clinical examination, nerve conduction studies, and possibly imaging studies to identify the underlying cause of the lesion. Treatment may include physical therapy, pain management, and in some cases, surgical intervention to relieve compression or repair the nerve. 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

  • Requires understanding of nerve anatomy and function
  • Differentiation from other neuropathies and nerve lesions
  • Potential for multiple underlying causes
  • Need for precise documentation of symptoms and diagnostic tests

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to specify laterality (left vs. right)
  • Misidentification of the nerve involved
  • Lack of supporting diagnostic tests in the medical record

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, including sensory and motor deficits.

Common Clinical Scenarios

Patients presenting with foot drop, pain, or sensory loss in the lower limb.

Billing Considerations

Documentation should clearly outline the neurological deficits and any diagnostic tests performed.

Orthopedics

Documentation Requirements

Surgical notes if applicable, imaging results, and functional assessments.

Common Clinical Scenarios

Post-traumatic nerve injuries or compression syndromes.

Billing Considerations

Ensure that the surgical intervention aligns with the diagnosis for accurate coding.

Coding Guidelines

Inclusion Criteria

Use G57.42 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation
  • Include details about the patient's symptoms, diagnostic tests, and any treatments provided
  • Ensure that the laterality is specified

Exclusion Criteria

Do NOT use G57.42 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95900CPT Code

Nerve conduction studies, each nerve; motor, sensory, or mixed

Clinical Scenario

Used to confirm the diagnosis of a nerve lesion.

Documentation Requirements

Document the specific nerves tested and the results.

Specialty Considerations

Neurology specialists should ensure comprehensive documentation of 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. G57.42 provides a clear indication of the affected nerve and its location, which is crucial for treatment and reimbursement.

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. G57.42 provides a clear indication of the affected nerve and its location, which is crucial for treatment and reimbursement.

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 a medial popliteal nerve lesion?

Common causes include trauma, compression from surrounding structures, and systemic conditions such as diabetes mellitus. Accurate diagnosis often requires a combination of clinical evaluation and diagnostic testing.