Practice Management Alert

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Choosing the Correct CRPS Code

Question: What diagnosis code should we report for chronic regional pain syndrome (CRPS) of the chest wall for ICD-9 and ICD-10?

West Virginia Subscriber

Answer: If your provider’s documentation clearly mentions CRPS type I of the chest wall, ICD-9 code 337.29 (Reflex sympathetic dystrophy of other specified site) is most appropriate diagnosis. The ICD-10 crosswalk code will be G90.59 (Complex regional pain syndrome I of other specified site).

If the documentation does not specify type I CRPS, you should probably report 786.52 (Painful respiration). Note that the code includes anterior chest wall pain, pleuritic pain, and pleurodynia. When you begin using ICD-10 in October, you’ll switch to either diagnosis code R07.1 (Chest pain on breathing) or R07.81 (Pleurodynia). 

CRPS is a chronic pain condition most often affecting one of the limbs (arms, legs, hands, or feet), usually after an injury or trauma to that limb. Scientists believe CRPS is caused by damage to, or malfunction of, the peripheral and central nervous systems.

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