G56.13
BillableOther lesions of median nerve, bilateral upper limbs
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is G56.13 an HCC code?
No. G56.13 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
G56.13 is the ICD-10-CM diagnosis code for other lesions of median nerve, bilateral upper limbs. Damage or injury to the median nerve affecting both arms, causing weakness, numbness, or pain in both hands. G56.13 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).
G56.13 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.
This code indicates bilateral involvement; document both upper limbs are affected to justify this code.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G56.13 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code indicates bilateral involvement; document both upper limbs are affected to justify this code
- •Consider if this is part of a systemic condition or separate injuries to each side