Orthopedic Coding Alert

ICD-10:

Here's How to Capture Carpal Tunnel Coding With Your New Diagnosis System

Published on Thu Nov 26, 2015

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Don’t miss this Excludes1 note under the G56 category.

When your orthopedist treats carpal tunnel syndrome, you now have several diagnosis options, based on the patient’s situation. Take a quick glance at how these diagnosis codes transitioned under ICD-10 back in October 2015.

When a patient suffers from carpal tunnel syndrome (CTS), she has a compression neuropathy. This can cause paresthesia, pain, numbness, and other symptoms in the distribution of the median nerve possibly due to its compression at the wrist in the carpal tunnel.

Possibility 1: Previous ICD-9 code 719.4x (Pain in joint) became more specific in ICD-10 to indicate where the patient experiences pain in the wrist. The ICD-10 codes are as follows:

M25.539 (Pain in unspecified wrist)
M25.531 (Pain in right wrist)
M25.532 (Pain in left wrist).

Possibility 2: Previous ICD-9 code 729.5 (Pain in limb) has become M79.6x (Pain in limb, hand, foot, fingers and toes …) and exploded with a range of options based on anatomic site. The extended codes provide you with 30 options, including right, left and unspecified sites of arm (M79.601-603); forearm (M79.631-632, 639); upper arm (M79.621-622, 629); hand (M79.641-43); fingers (M79.644-646); thigh (M79.651-52,659); leg (M79.604-605); lower leg (M79.661-662,669); feet (M79.671-673); and toe (M79.674-76). You’ll report M79.609 for pain in an unspecified limb.

Possibility 3: Previous ICD-9 diagnosis 728.87 (Muscle weakness [generalized]) will be an easy one to remember because it retains the same descriptor with M62.81.

Final note: Under ICD-9, diagnosis 354.0 (Carpal tunnel syndrome) is coupled with mononeuritis of upper limb and mononeuritis multiplex. The ICD-10 system offers more clarity with separate codes for unspecified upper, right, and left limbs, as follows:

G56.00 (Carpal tunnel syndrome, unspecified upper limb)
G56.01 (Carpal tunnel syndrome, right upper limb)
G56.02 (Carpal tunnel syndrome, left upper limb).

Coder tips: Under the G56 category, you’ll find an Excludes1 note that prevents you from reporting CTS with “current traumatic nerve disorder - see nerve injury by body region.”