G90.519
BillableComplex regional pain syndrome I of unspecified upper limb
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Complex regional pain syndrome type I is a chronic pain condition affecting an arm or hand, typically following an injury, that causes disproportionate pain, swelling, and changes in skin color or temperature. This code is used when the specific arm (left or right) is not documented.
Coding Tips
- •Verify documentation to determine if the condition affects the right or left upper limb; if specified, use G90.511 (right) or G90.512 (left) instead of the unspecified code
- •Ensure the diagnosis clearly indicates CRPS type I (formerly called RSD) rather than type II, and document the triggering event or injury when possible to support medical necessity
Code Hierarchy
└G90Disorders of autonomic nervous system└G90.5Complex regional pain syndrome I (CRPS I)└G90.51Complex regional pain syndrome I of upper limb└G90.519Complex regional pain syndrome I of unspecified upper limb
└G90.519Complex regional pain syndrome I of unspecified upper limb