G56.03
BillableCarpal tunnel syndrome, bilateral upper limbs
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is G56.03 an HCC code?
No. G56.03 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
G56.03 is the ICD-10-CM diagnosis code for carpal tunnel syndrome, bilateral upper limbs. Carpal tunnel syndrome affecting both upper limbs, where the median nerve is compressed at both wrists causing bilateral pain, numbness, and tingling in both hands. G56.03 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering nerve, nerve root and plexus disorders (g50-g59).
G56.03 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Use this code only when carpal tunnel syndrome is documented in both the right and left upper limbs.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G56.03 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when carpal tunnel syndrome is documented in both the right and left upper limbs
- •Bilateral presentation may suggest systemic causes; document any associated conditions like rheumatoid arthritis or diabetes