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ICD-10 Guide
ICD-10 CodesG57.71

G57.71

Billable

Causalgia of right lower limb

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

Code Description

ICD-10 G57.71 is a billable code used to indicate a diagnosis of causalgia of right lower limb.

Key Diagnostic Point:

Causalgia, also known as complex regional pain syndrome type II, is characterized by severe, persistent pain in the right lower limb that is often accompanied by sensory abnormalities, motor dysfunction, and autonomic changes. This condition typically arises following a nerve injury, leading to an exaggerated response to pain stimuli. Patients may experience burning pain, allodynia (pain from stimuli that do not normally provoke pain), and hyperalgesia (increased sensitivity to painful stimuli). The pain can be debilitating and may be associated with swelling, changes in skin color, and temperature differences in the affected limb. Diagnosis is primarily clinical, supported by patient history and physical examination, and may involve nerve conduction studies to assess the integrity of the affected nerve. Treatment often includes pain management strategies, physical therapy, and sometimes nerve blocks or surgical interventions. Understanding the underlying nerve pathology is crucial for effective management and coding of this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of nerve injury mechanisms
  • Differentiation from other neuropathic pain conditions
  • Need for detailed documentation of symptoms and history
  • Potential for co-morbid conditions affecting coding

Audit Risk Factors

  • Inadequate documentation of pain severity and duration
  • Failure to document prior treatments and their outcomes
  • Misclassification of causalgia as other pain syndromes
  • 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, and results from nerve conduction studies.

Common Clinical Scenarios

Patients presenting with chronic pain following a traumatic injury or surgery, with neurological deficits.

Billing Considerations

Ensure comprehensive documentation of the patient's pain history and response to treatments to support the diagnosis.

Pain Management

Documentation Requirements

Records of pain management strategies employed, including medications, physical therapy, and interventional procedures.

Common Clinical Scenarios

Patients undergoing multimodal pain management for chronic pain syndromes.

Billing Considerations

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

Coding Guidelines

Inclusion Criteria

Use G57.71 When
  • According to ICD
  • 10 guidelines, G57
  • 71 should be used when the primary diagnosis is causalgia of the right lower limb
  • It is essential to document the specific nature of the pain and any associated symptoms

Exclusion Criteria

Do NOT use G57.71 When
  • Exclusion criteria include conditions that do not involve nerve injury or are classified under different neuropathic pain codes

Related ICD-10 Codes

Related CPT Codes

95903CPT Code

Nerve conduction study, motor and sensory

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 the study is clearly documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of causalgia, improving the ability to capture the complexity of nerve-related pain conditions. This specificity aids in better tracking of treatment outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of causalgia, improving the ability to capture the complexity of nerve-related pain conditions. This specificity aids in better tracking of treatment outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of causalgia, improving the ability to capture the complexity of nerve-related pain conditions. This specificity aids in better tracking of treatment 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 is causalgia?

Causalgia is a chronic pain condition that occurs following a nerve injury, characterized by severe burning pain and sensory abnormalities in the affected limb.

How is causalgia diagnosed?

Diagnosis is primarily clinical, based on patient history and physical examination, often supplemented by nerve conduction studies to assess nerve function.

What are common treatments for causalgia?

Treatment may include pain management strategies, physical therapy, nerve blocks, and in some cases, surgical interventions.