G90.521 ICD-10-CM Code: Complex regional pain syndrome I of right lower limb

G90.521 is the ICD-10-CM diagnosis code for complex regional pain syndrome i of right lower limb. Complex regional pain syndrome I (CRPS I) is a chronic pain condition affecting the right lower limb, typically occurring after an injury or trauma, characterized by severe pain, swelling, and changes in skin color and temperature. It involves dysfunction of the peripheral and central nervous systems causing disproportionate pain relative to the initial injury. G90.521 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).

G90.521 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.

Verify the laterality is documented as right lower limb and confirm CRPS I (not CRPS II, which involves confirmed nerve injury) before assigning this code.