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ICD-10 Guide
ICD-10 CodesG90.522

G90.522

Billable

Complex regional pain syndrome I of left lower limb

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

Code Description

ICD-10 G90.522 is a billable code used to indicate a diagnosis of complex regional pain syndrome i of left lower limb.

Key Diagnostic Point:

Complex Regional Pain Syndrome (CRPS) I, previously known as Reflex Sympathetic Dystrophy (RSD), is a chronic pain condition that typically affects a limb following an injury or trauma. In the case of G90.522, the syndrome is localized to the left lower limb. Patients often experience severe, persistent pain that is disproportionate to the initial injury. Symptoms may include swelling, changes in skin color and temperature, and abnormal sweating in the affected area. The pain is often described as burning or throbbing and may be accompanied by sensory abnormalities such as allodynia (pain from stimuli that do not normally provoke pain) and hyperalgesia (increased sensitivity to pain). The exact pathophysiology of CRPS is not fully understood but is believed to involve a combination of peripheral and central nervous system changes, including dysregulation of the autonomic nervous system. Diagnosis is primarily clinical, based on the history of pain and associated symptoms, and may be supported by imaging studies or nerve conduction tests. Early diagnosis and intervention are crucial for improving outcomes and reducing the risk of chronic pain.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptom presentation among patients
  • Need for comprehensive clinical documentation to support diagnosis
  • Potential overlap with other pain syndromes
  • Requirement for multidisciplinary approach in treatment

Audit Risk Factors

  • Inadequate documentation of the initial injury or trauma
  • Failure to document the severity and duration of symptoms
  • Lack of evidence for the diagnosis of CRPS
  • Inconsistent coding of related conditions

Specialty Focus

Medical Specialties

Pain Management

Documentation Requirements

Detailed pain assessments, treatment plans, and response to therapies.

Common Clinical Scenarios

Patients presenting with chronic pain following an injury, requiring multimodal pain management strategies.

Billing Considerations

Documentation must clearly outline the relationship between the injury and the development of CRPS.

Neurology

Documentation Requirements

Neurological evaluations, imaging studies, and differential diagnosis documentation.

Common Clinical Scenarios

Patients with neurological symptoms following trauma, requiring assessment for CRPS versus other neuropathic conditions.

Billing Considerations

Neurologists should document any autonomic dysfunction and sensory abnormalities to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use G90.522 When
  • According to ICD
  • 10 guidelines, G90
  • 522 should be used when the patient has a confirmed diagnosis of CRPS I localized to the left lower limb
  • It is important to document the onset of symptoms, any prior treatments, and the impact on daily functioning

Exclusion Criteria

Do NOT use G90.522 When
  • Exclusion criteria include conditions that mimic CRPS symptoms but are not classified as CRPS

Related ICD-10 Codes

Related CPT Codes

64450CPT Code

Injection, anesthetic agent into a major nerve or branch

Clinical Scenario

Used for pain management in patients diagnosed with CRPS.

Documentation Requirements

Document the specific nerve targeted and the patient's response to the injection.

Specialty Considerations

Pain management specialists should ensure comprehensive documentation of the patient's pain history.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like CRPS, improving the ability to track and manage these complex pain syndromes. The granularity of ICD-10 codes helps in better understanding the epidemiology and treatment outcomes of CRPS.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like CRPS, improving the ability to track and manage these complex pain syndromes. The granularity of ICD-10 codes helps in better understanding the epidemiology and treatment outcomes of CRPS.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like CRPS, improving the ability to track and manage these complex pain syndromes. The granularity of ICD-10 codes helps in better understanding the epidemiology and treatment outcomes of CRPS.

Resources

Clinical References

  • •
    American Academy of Pain Medicine

Coding & Billing References

  • •
    American Academy of Pain Medicine

Frequently Asked Questions

What are the common symptoms of CRPS I?

Common symptoms include severe pain, swelling, changes in skin color and temperature, and abnormal sweating in the affected limb.

How is CRPS I diagnosed?

Diagnosis is primarily clinical, based on the patient's history of pain and associated symptoms, and may be supported by imaging studies or nerve conduction tests.