ICD-10 Coding for Piriformis Muscle Syndrome(G57.01, G57.02, G57.00)
Complete ICD-10-CM coding and documentation guide for Piriformis Muscle Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Piriformis Muscle Syndrome
G57.00-G57.02Primary Range
Lesion of sciatic nerve
Primary range for coding piriformis muscle syndrome due to sciatic nerve compression.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G57.01 | Lesion of sciatic nerve, right lower limb | Use when piriformis syndrome affects the right side with documented sciatic nerve involvement. |
|
| G57.02 | Lesion of sciatic nerve, left lower limb | Use when piriformis syndrome affects the left side with documented sciatic nerve involvement. |
|
| G57.00 | Lesion of sciatic nerve, unspecified lower limb | Use when laterality is not specified but piriformis syndrome is confirmed. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for piriformis muscle syndrome
Essential facts and insights about Piriformis Muscle Syndrome
Primary ICD-10-CM Codes for piriformis muscle syndrome
Decision Criteria
clinical Criteria
- Documented sciatic nerve compression with positive clinical tests.
Applicable To
- Sciatic nerve compression due to piriformis syndrome
Excludes
- Lumbar radiculopathy
Clinical Validation Requirements
- Positive Pace sign
- Positive FAIR test
- EMG showing delayed H-reflex latency
Code-Specific Risks
- Incorrect laterality specification
Coding Notes
- Ensure laterality is specified to avoid denials.
G57.02 - Lesion of sciatic nerve, left lower limb
Use when piriformis syndrome affects the left side with documented sciatic nerve involvement.
Applicable To
- Sciatic nerve compression due to piriformis syndrome
Excludes
- Lumbar radiculopathy
Clinical Validation Requirements
- Positive Pace sign
- Positive FAIR test
- EMG showing delayed H-reflex latency
Coding Notes
Ensure laterality is specified to avoid denials.
G57.00 - Lesion of sciatic nerve, unspecified lower limb
Use when laterality is not specified but piriformis syndrome is confirmed.
Applicable To
- Sciatic nerve compression due to piriformis syndrome
Excludes
- Lumbar radiculopathy
Clinical Validation Requirements
- Positive Pace sign
- Positive FAIR test
- EMG showing delayed H-reflex latency
Coding Notes
Specify laterality if possible to improve claim accuracy.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other muscle spasm
M62.838Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Piriformis Muscle Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G57.01.
Impact
Clinical: Inaccurate diagnosis and treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials and revenue loss.
Mitigation Strategy
Always specify laterality in clinical documentation., Double-check EMR entries for completeness.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on procedure types performed.
Mitigation Strategy
Use 20552 for trigger point injections into the piriformis muscle.
Impact
Failure to specify laterality can lead to audit flags.
Mitigation Strategy
Ensure all documentation includes laterality where applicable.
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 Piriformis Muscle Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Piriformis Muscle Syndrome
Use these documentation templates to ensure complete and accurate documentation for Piriformis Muscle Syndrome. These templates include all required elements for proper coding and billing.
Piriformis syndrome with right-sided symptoms
Specialty: OrthopedicsRequired Elements
- Physical exam findings
- Positive clinical tests
- Imaging results
- Injection details
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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