Neurosurgery Coding Alert

Question: I’m so confused. I’ve seen the terms reflex sympathetic dystrophy (RSD) and complex regional pain syndrome I (CRPS-I) used interchangeably in my neurosurgeon’s medical documentation. Do these two terms refer to the same condition? What ICD-10 code should I report for complex regional pain syndrome I of the patient’s right upper limb?

Texas Subscriber

Answer: You should report G90.511 (Complex regional pain syndrome I of right upper limb) for complex regional pain syndrome I of the patient’s right upper limb.

When ICD-9 switched to ICD-10, CMS updated the old name for reflex sympathetic dystrophy (RSD) to the current name — complex regional pain syndrome (CRPS) Type I. If you look in the current ICD-10 code book, you will find reflex sympathetic dystrophy as an included condition for the codes in category G90.5- (Complex regional pain syndrome I (CRPS I)). So, yes, RSD and CRPS-I refer to the same condition.

CRPS defined: CRPS is a chronic pain condition that most often affects a patient’s limb usually after an injury. Experts believe that CRPS is caused by damage to or malfunction of the patient’s peripheral and central nervous system (CNS).

CRPS is classified into two types: CRPS-I and CRPS-II. When a patient doesn’t not have a confirmed nerve injury, then he has CRPS-1.

On the other hand, CRPS-II is known as causalgia and represents when the physician can trace the patient’s pain to an identifiable nerve injury.