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ICD-10 Guide
ICD-10 CodesG57.70

G57.70

Billable

Causalgia of unspecified lower limb

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

Code Description

ICD-10 G57.70 is a billable code used to indicate a diagnosis of causalgia of unspecified lower limb.

Key Diagnostic Point:

Causalgia, also known as complex regional pain syndrome (CRPS), is a chronic pain condition that typically follows an injury or trauma to a limb. It is characterized by severe burning pain, swelling, and changes in skin color and temperature in the affected area. In the case of G57.70, the causalgia is specified as occurring in the lower limb, but without further specification regarding the exact location or underlying cause. The pain associated with causalgia is often disproportionate to the initial injury and can be exacerbated by emotional stress or physical activity. The condition may involve nerve damage or dysfunction, leading to abnormal pain signaling. Diagnosis is primarily clinical, based on patient history and symptomatology, and may be supported by nerve conduction studies to assess the function of the affected nerves. Treatment options include physical therapy, medications for pain management, and in some cases, nerve blocks or surgical interventions. Accurate coding is essential for proper reimbursement and to ensure that the patient's condition is appropriately documented in their medical record.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of symptoms
  • Need for comprehensive documentation to support the diagnosis
  • Potential overlap with other neuropathic pain conditions
  • Variability in treatment approaches and response

Audit Risk Factors

  • Inadequate documentation of the patient's history and symptoms
  • Failure to specify the affected limb when applicable
  • Lack of supporting evidence from nerve conduction studies
  • Inconsistent coding practices among providers

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, patient history, and results from nerve conduction studies.

Common Clinical Scenarios

Patients presenting with chronic pain following an injury, with symptoms consistent with causalgia.

Billing Considerations

Ensure that all relevant diagnostic tests are documented to support the diagnosis of causalgia.

Pain Management

Documentation Requirements

Comprehensive pain assessments, treatment plans, and responses to interventions.

Common Clinical Scenarios

Patients undergoing pain management therapies for chronic pain syndromes, including causalgia.

Billing Considerations

Document the effectiveness of pain management strategies and any changes in the patient's condition.

Coding Guidelines

Inclusion Criteria

Use G57.70 When
  • According to ICD
  • 10 coding guidelines, G57
  • 70 should be used when causalgia is diagnosed without specification of the affected limb
  • Coders must ensure that the diagnosis is supported by clinical documentation and that other potential causes of neuropathic pain are ruled out

Exclusion Criteria

Do NOT use G57.70 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

95903CPT Code

Nerve conduction study, each nerve

Clinical Scenario

Used to evaluate nerve function in patients with suspected causalgia.

Documentation Requirements

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

Specialty Considerations

Neurologists should ensure that the rationale for testing is clearly stated.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of causalgia, enabling better tracking of the condition and its treatment outcomes. This specificity aids in research and improves the understanding of causalgia as a distinct clinical entity.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of causalgia, enabling better tracking of the condition and its treatment outcomes. This specificity aids in research and improves the understanding of causalgia as a distinct clinical entity.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of causalgia, enabling better tracking of the condition and its treatment outcomes. This specificity aids in research and improves the understanding of causalgia as a distinct clinical entity.

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 is causalgia?

Causalgia is a chronic pain condition that arises after an injury, characterized by severe burning pain and other symptoms in the affected limb.

How is causalgia diagnosed?

Diagnosis is primarily clinical, based on patient history and symptoms, and may be supported by nerve conduction studies.

What are the treatment options for causalgia?

Treatment may include physical therapy, medications for pain management, and interventional procedures such as nerve blocks.