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G90.5 ICD-10-CM Code: Complex regional pain syndrome I (CRPS I)

ICD-10-CM Code View

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FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Other disorders of the nervous system (G89-G99)

G90.5

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Complex regional pain syndrome I (CRPS I)

Complex regional pain syndrome I (CRPS I)

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
G90Disorders of autonomic nervous system
G90.5Complex regional pain syndrome I (CRPS I)

Inclusion Terms

Official
  • Reflex sympathetic dystrophy

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for G90.5 in this effective period.

Related Child Codes

Official
G90.50Complex regional pain syndrome I, unspecified
G90.51Complex regional pain syndrome I of upper limb
G90.52Complex regional pain syndrome I of lower limb
G90.59Complex regional pain syndrome I of other specified site

Includes

Official

ICD-10-CM does not list Includes notes for G90.5 in this effective period.

Excludes 1

Official
  • causalgia of lower limb (G57.7-)
  • causalgia of upper limb (G56.4-)
  • complex regional pain syndrome II of lower limb (G57.7-)
  • complex regional pain syndrome II of upper limb (G56.4-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for G90.5 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for G90.5 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for G90.5 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Coder workflow notes

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What This Code Means

G90.5 is the ICD-10-CM diagnosis code for complex regional pain syndrome i (crps i). G90.5 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering other disorders of the nervous system (g89-g99).

Header codes like G90.5 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 G90.5'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 G90.5 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • causalgia of lower limb (G57.7-)
  • causalgia of upper limb (G56.4-)
  • complex regional pain syndrome II of lower limb (G57.7-)
  • complex regional pain syndrome II of upper limb (G56.4-)

Child Codes

Code Hierarchy

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