Internal Medicine Coding Alert
Coding Differs for Median Neuritis, Carpal Tunnel
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Question: What's the difference between 354.0 (Carpal tunnel syndrome--Median nerve entrapment) and 354.1 (Other lesion of median nerve--Median nerve neuritis)? Answer: Yes, the symptoms for both are very similar--the thumb, index and middle fingers are tingling, numb and painful. But the pathophysiology is very different. Answers to You Be the Coder and Reader Questions were reviewed by Kathy Pride, CPC, CCS-P, director of government program services for QuadraMed in Reston, Va.; and Bruce Rappoport, MD, CPC, a board-certified internist who works with physicians on compliance, documentation, coding and quality issues for Rachlin, Cohen & Holtz LLP, a Fort Lauderdale, Fla.-based accounting firm with healthcare expertise.
The symptoms seem to be exactly the same.
Michigan Subscriber
Carpal tunnel syndrome (354.0) happens when there's inflammation in the wrist's transverse carpal ligament--a band of thick connective tissue that forms the tunnel.
Median nerve neuritis (354.1) is an inflammation of the actual nerve, so it's not the same as carpal tunnel syndrome. Frequently, anti-inflammatory medications or braces will treat carpal tunnel syndrome, but they won't treat median nerve neuritis. And a patient can have both at the same time.
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