2025 ICD-10-CM code G90.51
(Valid) Effective Date: N/A Diseases of the nervous system - Other disorders of the nervous system 6 (Diseases of the Nervous System) Feed
Complex regional pain syndrome I (CRPS I) of an upper limb.
Medical necessity must be established by demonstrating the presence of characteristic signs and symptoms of CRPS I and the impact on the patient's functional abilities. The documentation should support the need for ongoing treatment and management of the condition.
Diagnosis is typically made by a neurologist, pain specialist, or other physician based on clinical presentation, patient history, and physical examination. Diagnostic tests may be used to rule out other conditions.
In simple words: CRPS I is a chronic pain condition of the arm or hand, often following an injury, even a minor one. The pain is much worse than expected, and the arm or hand may swell, change color and temperature, or sweat excessively.
Complex regional pain syndrome I (CRPS I), formerly known as reflex sympathetic dystrophy (RSD), is a chronic pain condition affecting an upper limb.It is characterized by pain disproportionate to the initial injury, along with swelling, changes in skin color and temperature, and vasomotor dysfunction. There is no demonstrable nerve injury in CRPS I.
Example 1: A patient experiences persistent burning pain, swelling, and skin color changes in their hand several weeks after a minor wrist fracture., Following a shoulder surgery, a patient develops severe pain, edema, and temperature sensitivity in their arm, exceeding the expected postoperative discomfort., A patient presents with chronic arm pain, allodynia, and vasomotor changes in their hand months after a fall, without any evidence of nerve damage on imaging studies.
Documentation should include the nature of the initial injury or event, a detailed description of the pain (location, quality, severity), associated symptoms (e.g., swelling, skin changes, movement limitations), and results of any diagnostic tests performed.
** CRPS I is a complex condition, and diagnosis and management often involve a multidisciplinary approach.
- Payment Status: Active
- Specialties:Neurology, Pain Management, Anesthesiology, Physical Medicine and Rehabilitation
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Independent Clinic, etc. (depending on the setting of care)