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G90.513

Billable

Complex regional pain syndrome I of upper limb, bilateral

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

A chronic pain condition affecting both arms or hands after injury, with swelling, skin color and temperature changes, and pain that seems worse than expected from the original injury.

Coding Tips

  • Bilateral coding requires documentation of symptoms in both upper limbs
  • Include the precipitating injury code when identified and documented

Code Hierarchy

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