G56.4 ICD-10-CM Code: Causalgia of upper limb
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Nerve, nerve root and plexus disorders (G50-G59)
G56.4
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceCausalgia of upper limb
Causalgia of upper limb
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Complex regional pain syndrome II of upper limb
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for G56.4 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for G56.4 in this effective period.
Excludes 1
Official- complex regional pain syndrome I of lower limb (G90.52-)
- complex regional pain syndrome I of upper limb (G90.51-)
- complex regional pain syndrome II of lower limb (G57.7-)
- reflex sympathetic dystrophy of lower limb (G90.52-)
- reflex sympathetic dystrophy of upper limb (G90.51-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for G56.4 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for G56.4 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for G56.4 in this effective period.
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
- Code
- G56.4
- Description
- Causalgia of upper limb
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- No
- Payment year
- 2026
Coder workflow notes
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What This Code Means
G56.4 is the ICD-10-CM diagnosis code for causalgia of upper limb. G56.4 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).
Header codes like G56.4 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at G56.4's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G56.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

