ICD-10 Coding for Brachial Plexopathy(G54.0)
Complete ICD-10-CM coding and documentation guide for Brachial Plexopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Brachial Plexopathy
G54-G54.9Primary Range
Nerve root and plexus disorders
This range includes codes for disorders of the brachial plexus, which is the primary focus for brachial plexopathy.
Injury of nerves at neck level
This range includes codes for traumatic injuries to the brachial plexus, which may be relevant in cases of trauma-induced plexopathy.
Key Information: ICD-10 code for brachial plexopathy
Essential facts and insights about Brachial Plexopathy
Primary ICD-10-CM Code for brachial plexopathy
Decision Criteria
clinical Criteria
- Presence of pain, weakness, or sensory loss localized to the brachial plexus.
coding Criteria
- Avoid using G54.0 for thoracic outlet syndrome unless vascular symptoms are present.
Applicable To
- Brachial neuritis
- Parsonage-Turner syndrome
Clinical Validation Requirements
- Pain, weakness, or sensory loss in upper extremity with localization to plexus
- EMG showing reduced CMAP amplitudes in C5-C6 distribution
- MRI findings of nerve root avulsion or edema
Code-Specific Risks
- Mixing with injury codes without proper sequencing
- Incorrectly coding thoracic outlet syndrome as G54.0
Coding Notes
- Ensure proper documentation of clinical findings and diagnostic tests to support coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Brachial Plexopathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G54.0.
Impact
Clinical: Incomplete clinical picture., Regulatory: Potential non-compliance with coding standards., Financial: Possible claim denials or reduced reimbursement.
Mitigation Strategy
Review patient history for trauma., Ensure proper code sequencing.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use G54.3 if Adson+ or vascular ultrasound shows compression.
Impact
Using G54.0 for conditions not meeting criteria.
Mitigation Strategy
Regular training on code differentiation and documentation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Brachial Plexopathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Brachial Plexopathy
Use these documentation templates to ensure complete and accurate documentation for Brachial Plexopathy. These templates include all required elements for proper coding and billing.
Post-surgical plexopathy
Specialty: NeurologyRequired Elements
- History of present illness
- Physical examination findings
- Diagnostic test results
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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