EM Coding Alert
Remember the Excludes1 Note on CTS ICD-10 Codes
Question: Could you explain how to report ICD-10 codes for carpal tunnel syndrome (CTS)? Our coders have had a problem transitioning from ICD-9 to ICD-10 on our CTS claims.
New York Subscriber
Answer: ICD-10 premiered in October of 2015, but some coders are still getting used to the intricacies of the new system. This is especially true for conditions like carpal tunnel syndrome (CTS), which barreled into ICD-10 with a barrage of new, more specific codes.
Master this code set, however, and put any CTS worries you have on ice. Check out this advice on choosing the best ICD-10 code for each CTS patient that your providers treat.
In ICD-10, the following CTS codes are available to the coder:
CTS: Under ICD-9, diagnosis 354.0 (Carpal tunnel syndrome) is coupled with mononeuritis of upper limb and mononeuritis multiplex. The ICD-10 system offers more clarity with the following codes:
Under the G56 category, you’ll find an Excludes1 note that prevents you from reporting CTS with “current traumatic nerve disorder — see nerve injury by body region.”
Patients might also present with complaints that are symptomatic of CTS. ICD-10 has made these codes more specific as well. Check out this rundown of the most common CTS symptoms, and how to walk the diagnoses to ICD-10.
Joint pain: The ICD-9 code 719.4x (Pain in joint) presents the following possibilities when coding the same condition with ICD-10:
Limb pain: The ICD-9 code 729.5 (Pain in limb) crosswalked to M79.6x (Pain in limb, hand, foot, fingers and toes …) and now features a range of options based on anatomic site. The extended codes provide you with 30 options, including right, left and unspecified sites of arm (M79.601-603); forearm (M79.631-632, 639); upper arm (M79.621-622, 629); hand (M79.641-43); fingers (M79.644-646); thigh (M79.651-52,659); leg (M79.604- 605); lower leg (M79.661-662,669); feet (M79.671-673); and toe (M79.674-76). You’ll report M79.609 for pain in an unspecified limb.
Muscle weakness: M62.81 (Muscle weakness [generalized]) will be an easy one to remember, as it retains the same descriptor as its ICD-9 predecessor.
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