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2025 ICD-10-CM code G90.5

Complex regional pain syndrome I (CRPS I)

Use G90.5 for CRPS I when there is no confirmed nerve injury.Do not use this code with codes for causalgia or CRPS II.

Modifiers may be applicable depending on the specific circumstances of the encounter. Consult official coding guidelines for appropriate modifier usage.

Medical necessity for treatment of CRPS I is established by the presence of persistent pain and functional limitations disproportionate to the original injury, along with other characteristic symptoms.Documentation should clearly demonstrate the impact of the condition on the patient's daily activities and quality of life.

Diagnosis of CRPS I involves evaluating the patient's medical history, symptoms, and conducting a physical and neurological examination.Diagnostic tests such as skin temperature readings, X-rays, thermographic tests, MRI, and bone scans may be used.Treatment requires a multidisciplinary approach, and may include medications, physical therapy, psychotherapy, and other interventions as appropriate. Clinicians should consider the psychological impact of CRPS and address any comorbidities.

IMPORTANT:G90.5 should not be used for CRPS II (which involves confirmed nerve injury), causalgia, or other specified types of complex regional pain syndromes.Refer to iFrameAI for a complete list of related and alternate codes.

In simple words: CRPS I is a long-lasting pain condition, usually in an arm or leg, that can develop after an injury, even a minor one. The pain is more severe than you'd expect and is accompanied by other symptoms like swelling, skin color changes, temperature differences, and trouble moving the limb.

Complex regional pain syndrome I (CRPS I), also known as reflex sympathetic dystrophy, is a chronic pain condition that typically affects a limb after an injury or trauma, but without demonstrable nerve damage.It is characterized by pain disproportionate to the initial injury, along with swelling, changes in skin color and temperature, and impaired mobility.

Example 1: A patient experiences persistent burning pain, swelling, and skin discoloration in their hand several weeks after a minor wrist fracture.No specific nerve damage is identified., Following a leg injury in a car accident, a patient develops severe pain, swelling, temperature changes, and limited range of motion in the affected limb, exceeding the expected recovery period.Imaging studies do not show nerve damage., A patient reports ongoing pain, hypersensitivity to touch, and changes in skin temperature and color in their foot months after an ankle sprain. Diagnostic tests do not reveal any nerve injury.

Documentation should include a detailed description of the patient's pain, associated symptoms (swelling, skin changes, temperature differences, mobility limitations), the inciting event or injury, the absence of confirmed nerve injury, and the results of any diagnostic tests performed.

** The information provided is current as of November 30, 2024, and may be subject to change. For the most up-to-date information, always consult the latest coding manuals and guidelines.iFrameAI offers additional resources for complex coding scenarios.

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iFrame™ AI's knowledge is aligned with and limited to the materials uploaded by users and should not be interpreted as medical, legal, or any other form of advice by iFrame™.