B02.22

Billable

Postherpetic trigeminal neuralgia

HCC Category Mapping

RxHCCHCC 168 — Trigeminal and Postherpetic Neuralgia

0.000

What This Code Means

Persistent nerve pain in the area supplied by the trigeminal nerve (affecting the face) that develops after a shingles infection in that region.

Coding Tips

•This is one of the most common postherpetic complications and may persist for months or years
•Document the distribution of pain (V1, V2, or V3 trigeminal division) when possible

Clinical Significance

Postherpetic trigeminal neuralgia is one of the most common and debilitating complications of herpes zoster, causing severe, persistent facial pain along trigeminal nerve distributions after shingles resolves. It significantly impacts quality of life and often requires multimodal pain management including anticonvulsants, antidepressants, and nerve blocks.

Documentation Requirements

✓History of herpes zoster in the trigeminal nerve distribution (ophthalmic V1, maxillary V2, or mandibular V3)
✓Pain persisting more than 90 days after rash onset (defining criterion for postherpetic neuralgia)
✓Specific trigeminal division affected (V1, V2, V3)
✓Pain characteristics: burning, stabbing, allodynia, hyperalgesia
✓Current pain management regimen and treatment response

Commonly Confused Codes

G50.0 (Trigeminal neuralgia, unspecified) — Idiopathic or vascular-related trigeminal neuralgia without postherpetic cause; B02.22 requires a preceding herpes zoster episode B02.21 (Postherpetic geniculate ganglionitis) — Affects the facial nerve/geniculate ganglion, not the trigeminal nerve B02.29 (Other postherpetic nervous system involvement) — Use B02.22 when the trigeminal nerve is specifically documented

Code Hierarchy

└B02Zoster [herpes zoster]└B02.2Zoster with other nervous system involvement └B02.22Postherpetic trigeminal neuralgia

└B02.22Postherpetic trigeminal neuralgia