Neurosurgery Coding Alert

You have a one-to-one match for reflex sympathetic dystrophy of sites other than limbs.

Here are the correct answers to the quiz for reflex sympathetic dystrophy. These will help you test your understanding of your ICD-10 options.

Answer 1: The correct answer is b, G90.511.

The ICD-9 code 337.21 (Reflex sympathetic dystrophy of the upper limb) maps to the following ICD-10 codes:

• G90.519, Complex regional pain syndrome I of unspecified upper limb
• G90.511, Complex regional pain syndrome I of right upper limb
• G90.512, Complex regional pain syndrome I of left upper limb
• G90.513, Complex regional pain syndrome I of upper limb, bilateral

Answer 2: The correct answer is d, G90.523.

Unlike ICD-9, ICD-10 offers more specific codes for bilateral complex regional pain syndrome. The ICD-9 code 337.22 (Reflex sympathetic dystrophy of the lower limb) maps to the following:

• G90.529, Complex regional pain syndrome I of unspecified lower limb
• G90.521, Complex regional pain syndrome I of right lower limb
• G90.522, Complex regional pain syndrome I of left lower limb
• G90.523, Complex regional pain syndrome I of lower limb, bilateral

Note: Your providers will need to be more specific in their documentation once you begin coding under ICD-10. Notes of “upper” or “lower” won’t be enough to pinpoint the best code at that point – you’ll also need to know “right,” “left,” or “bilateral.”

Answer 3: The correct answer is a, G90.59.

You report ICD-10 code G90.59 (Complex regional pain syndrome I of other specified site) for complex regional pain syndrome I of the chest. This code is a one-to-one match for ICD-9 code 337.29 (Reflex sympathetic dystrophy of other specified site). This could include non-extremity sites such as the chest, breast, or abdomen. 

Answer 4: The correct answer is a, true.

ICD-10 will switch to an updated terminology for RSD. ICD-10 lists the condition under complex regional pain syndrome (CRPS). CRPS Type I is the current worldwide term for this condition, replacing the old name of RSD (CRSP Type II represents causalgia). “This is a good example of one of the ICD-10 improvements: updated medical terminology and classification of diseases,” says Marvel Hammer, RN, CPC, CCS-P, ACS-PM, CPCO, owner of MJH Consulting in Denver, Co. 

Answer 5: The correct option is c, G90.50.

When your physician does not document the site for the reflex sympathetic dystrophy, you have specific codes in ICD-10. You report ICD-10 code G90.50 (Complex regional pain syndrome I, unspecified).