Neurology & Pain Management Coding Alert

Question 2: What are the different types of CRPS?

Answer: CRPS is a chronic pain condition that most often affects a patient’s limb usually after an injury. CRPS is caused by damage to or malfunction of the patient’s peripheral and central nervous system (CNS).

CRPS is typically classified into two different types: CRPS I and CRPS II.

CRPS I: When a patient doesn’t not have a confirmed nerve injury, then he has CRPS I.

CRPS II: On the other hand, CRPS II is known as causalgia and represents when your physician can trace the patient’s pain to an identifiable nerve injury.

Check Out CRPS I Diagnostic Tools

Question 3: How will my provider diagnose CRPS I?

Answer: Your physician will diagnose CRPS I based upon the patient’s medical history, signs and symptoms, and by performing physical and neurological examination. Your physician may also use skin temperature readings, X-rays, thermographic tests, magnetic resonance imaging (MRIs), and triphasic bone scans as diagnostic tools for this condition.

Provider May Rely on These CRPS I Treatment Options

Question 4: What are some possible treatment options for CRPS I?

Answer: Your provider may be able to treat the patient’s CRPS I if he catches it early; however, some cases of this condition do not respond to treatment. Your provider may prescribe anesthetic creams, antidepressants, nonsteroidal anti-inflammatory drugs (NSAIDs), anticonvulsants, corticosteroids, nerve–blocking injections, and opioids, any of which may be helpful.

Additionally, physical therapy, psychotherapy, and splints to ease hand pain could be helpful for patients.

Turn to G90.512 for CRPS I of Left Upper Limb

Question 5: Which ICD-10-CM code should I report for CRPS I of the left upper limb?

Answer: You should report G90.512 (Complex regional pain syndrome I of left upper limb) for CRPS I of the left upper limb.

Don’t miss: Patients with CRPS I of their left upper limb may experience symptoms such as:

• Constant and severe pain in their left arm;
• Changes in skin color;
• Temperature changes;
• Swelling in the left arm, which may spread beyond the injury site;
• Changes in hair or nail growth;
• Excessive sweating;
• Muscle weakness;
• Joint stiffness; or
• An inability to move their left arm

Patient Has Bilateral CRPS I? Do This

Question 6: Which of the following ICD-10 codes do you report for CRPS I of both the patient’s right and left lower limbs?

Answer: You should report G90.523 (Complex regional pain syndrome I of lower limb, bilateral) for this bilateral condition.

As you can see, you must check your physician’s medical documentation carefully to check for “right,” “left,” or “bilateral” CRPS I, as well as “upper” or “lower” because you have specific ICD-10-CM codes to choose from.

Understand Unspecified CRPS I Code

Question 7: My physician documented CRPS I, but he did not specify the exact site. Which ICD-10-CM code should I report?

Answer: If your physician does not document whether the CRPS I affects the patient’s upper or lower extremity, you should report the unspecified code: G90.50 (Complex regional pain syndrome I, unspecified).