G56.80 Other specified mononeuropathies of unspecified upper limb

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1 ICD-9-CM Description ICD-9-CM Diagnosis Code ICD-10-CM Diagnosis Code ICD-10- CM Description Indicated as an aid in the management of chronic intractable pain of the trunk and/or limbs, including unilateral or bilateral pain associated with failed back surgery syndrome, intractable low back pain and leg pain. Chronic Pain Disorders: Central pain syndrome G89.0 Central Pain Syndrome Chronic pain due to trauma G89.21 Chronic pain due to trauma Other chronic post-thoracotomy pain G89.22 Chronic pain post-throractomy pain Other chronic postoperative pain G89.28 Other chronic postprocedural pain Other chronic pain G89.29 Other chronic pain Chronic pain syndrome G89.4 Chronic pain syndrome Fitting and adjustment of neuropacemaker (brain) (peripheral nerve) (spinal cord). For routine device replacement and the secondary diagnosis is for the underlying pain condition Reflex Sympathetic Dystrophy & Causalgia: V53.02 Z45.42 Encounter for adjustment and management of neuropacemaker (brain) (peripheral nerve) (spinal cord) Reflex sympathetic dystrophy, G90.50 Complex al pain syndrome I, Reflex Sympathetic Dystrophy of the upper limb (complex al pain syndrome G Complex al pain syndrome I of right upper limb Type 1) G Complex al pain syndrome I of left upper limb G Complex al pain syndrome I of upper limb, bilateral G Complex al pain syndrome I of upper limb Reflex Sympathetic Dystrophy of the lower limb (complex al pain syndrome Type 1) G Complex al pain syndrome I of right lower limb G Complex al pain syndrome I of left lower limb G Complex al pain syndrome I of lower limb, bilateral G Complex al pain syndrome I of lower limb Reflex sympathetic dystrophy of other specified site (complex al pain G90.59 Complex al pain syndrome I of other specified site syndrome Type 1) Causalgia of upper limb (complex al pain syndrome Type II) G56.40 Causalgia of upper limb G56.41 Causalgia of right upper limb G56.42 Causalgia of left upper limb G56.43 Causalgia of bilateral upper limbs Mononeuritis multiplex G58.7 Mononeuritis multiplex Other mononeuritis of upper limb G56.80 Other specified mononeuropathies of upper limb Mononeuritis of upper limb, Causalgia of lower limb (complex al pain syndrome Type II) Other mononeuritis of lower limb Mononeuritis of lower limb, Mononeuritis of site G56.81 Other specified mononeuropathies of right upper limb G56.82 Other specified mononeuropathies of left upper limb G56.83 Other specified mononeuropathies of bilateral upper limbs G56.90 Unspecified mononeuropathy of upper limb G56.91 Unspecified mononeuropathy of right upper limb G56.92 Unspecified mononeuropathy of left upper limb G56.93 Unspecified mononeuropathy of bilateral upper limbs G57.70 Causalgia of lower limb G57.71 Caulsalgia of right lower limb G57.72 Caulsalgia of left lower limb G57.73 Causalgia of bilateral lower limbs G57.80 Other specified mononeuropathies of lower limb G57.81 Other specified mononeuropathies of right lower limb G57.82 Other specified mononeuropathies of left lower limb G57.83 Other specified mononeuropathies of bilateral lower limbs G57.90 Unspecified mononeuropathy of lower limb G57.91 Unspecified mononeuropathy of right lower limb G57.92 Unspecified mononeuropathy of left lower limb G57.93 Unspecified mononeuropathy of bilateral lower limbs G58.8 Other specified mononeuropathies G58.9 Mononeuropathy, G59 Mononeuropathy in diseases classified elsewhere

2 Underlying Causes of Chronic Pain: Herpes zoster with nervous system complication B02.29 Other postherpetic nervous system involvement Postherpetic trigeminal neuralgia B02.22 Postherpetic trigeminal neuralagia Postherpetic polyneuropathy B02.23 Postherpetic polyneuropathy Herpes zoster with other nervous system complication B02.29 Other postherpetic nervous system involvement Nonpyogenic meningitis G03.0 Nonpyogenic meningitis Eosinophilic meningitis G03.8 Meningitis due to other specified causes Chronic meningitis G03.1 Chronic meningitis Meningitis, G03.9 Meningitis, Disorders of meninges, not elsewhere classified G96.12 Meningeal adhesions (cerebral) (spinal) G96.19 Other disorders of meninges, not elsewhere classified Unspecified disorders of nervous system G96.9 Disorder of central nervous system, Lumbosacral plexus lesions G54.1 Lumbosacral plexus disorders Cervical root lesions, not elsewhere classified G54.2 Cervical root disorders, not elsewhere classified Thoracic root lesions, not elsewhere classified G54.3 Thoracic root disorders,not elsewhere classified Lumbosacral root lesions, not elsewhere classified G54.4 Lumbosacral root disorders, not elsewhere classified Neuraligic amyotrohpy G54.5 Neuralagic amytrophy Phantom limb (syndrome) G54.6 Phantom limb syndrome with pain G54.7 Phantom limb syndrome without pain Other nerve root and plexus disorders [intercostal neuralgia] G54.8 Other nerve root and plexus disorders Unspecified nerve root and plexus disorder G54.9 Nerve root and plexus disorder, Hereditary peripheral neuropathy G60.0 Hereditary motor and sensory neuropathy Hereditary peripheral neuropathy, G60.9 Heredity and idiopathetic neuropathy, Ankylosing spondylitis M45.0 Ankylosing spondylitis of multiple sites in spine M45.1 Ankylosing spondylitis of occipito-atlanto-axial M45.2 Ankylosing spondylitis cervical M45.3 Ankylosing spondylitis cervicothoracic M45.4 Ankylosing spondylitis thoracic M45.5 Ankylosing spondylitis thoracolumbar M45.6 Ankylosing spondylitis lumbar M45.7 Ankylosing spondylitis lumbosacral M45.8 Ankylosing spondylitis sacral and sacrococcygeal M45.9 Ankylosing spondylitis of sites in spine M08.1 Juvenile ankylosing spondylitis Spinal enthesopathy M46.00 Spinal enthesopathy, site M46.01 Spinal enthesopathy, occipito-atlanto-axial M46.02 Spinal enthesopathy, cervical M46.03 Spinal enthesopathy, cervicothoracic M46.04 Spinal enthesopathy, thoracic M46.05 Spinal enthesopathy, thoracolumbar M46.06 Spinal enthesopathy, lumbar M46.07 Spinal enthesopathy, lumbosacral regio M46.08 Spinal enthesopathy, sacral and sacrococcygeal M46.09 Spinal enthesopathy, multiple sites in spine Cervical spondylosis without myelopathy M Spondylosis without myelopathy or radiculopathy, cervical M Spondylosis without myelopathy or radiculopathy, cervicothoracic Cervical spondylosis with myelopathy M Anterior spinal artery compression syndromes, occipitoatlanto-axial M Anterior spinal artery compression syndromes, cervical M Anterior spinal artery compression syndromes, cerviocothoracic M Anterior spinal artery compression syndromes, thoracic,

3 M Anterior spinal artery compression syndromes, thoracolumbar M Anterior spinal artery compression syndromes, lumbar M Anterior spinal artery compression syndromes, site M Vertrbral artery compression syndromes, occipito-atlantoaxial M Vertrbral artery compression syndromes, cervical M Vertrbral artery compression syndromes, site M47.11 Other spondylosis with myelopathy, occipito-atlanto-axial M47.12 Other spondylosis with myelopathy, cervical M47.13 Other spondylosis with myelopathy,cerviocothoracic Thoracic spondylosis without myelopathy M Spondylosis without myelopathy or radiculopathy, thoracic M Spondylosis without myleopathy or radiculopathy, thoracolumbar Lumbosacral spondylosis without myleopathy M Spondylosis without myelopathy or radiculopathy, lumbosacral Thoracic spondylosis with myelopathy M47.14 Other spondylosis with myelopathy, thoracic M47.15 Other spondylosis with myelopathy, thoracolumbar Lumbar spondylosis with myelopathy M47.16 Other spondylosis with myelopathy, lumbar Ankylosing vertebral hyperostosis M48.10 Ankylosing hyperostosis (Forestier), site M48.11 Ankylosing hyperostosis (Forestier), occipito-atlanto-axial M48.12 Ankylosing hyperostosis (Forestier), cervical M48.13 Ankylosing hyperostosis (Forestier), cerviocothoracic M48.14 Ankylosing hyperostosis (Forestier), thoracic M48.15 Ankylosing hyperostosis (Forestier), thoracolumbar M48.16 Ankylosing hyperostosis (Forestier), lumbar M48.17 Ankylosing hyperostosis (Forestier), lumbosacral M48.18 Ankylosing hyperostosis (Forestier), sacral and sacrococcygeal M48.19 Ankylosing hyperostosis (Forestier), multiple sites in spine Other allied disorders of spine M48.9 Spondylopathy, Spondylosis of site, without mention of myelopathy M Spondylosis without myelopathy or radiculopathy, site Spondylosis of site, with mention of myelopathy M47.10 Other spondylosis with myelopathy, site Displacement of cervical intervertebral disc without myelopathy M50.20 Other cervical disc displacement, cervical Displacement of lumbar intervertebral disc without myelopathy Displacement of thoracic intervertebral disc without myelopathy M50.21 Other cervical disc displacement, high cervical M Other cervical disc displacement, mid-cervical, level M Other cervical disc displacement at C4-C5 level M Other cervical disc displacement at C5-C6 level M Other cervical disc displacement at C6-C7 level M50.23 Other cervical disc displacement, cerviothoracic M51.26 Other intervertebral disc displacement, lumbar M51.27 Other intervertebral disc displacement, lumbosacral M51.24 Other intervertebral disc displacement, thoracic M51.25 Other intervertebral disc displacement, thoracolumbar

4 Displacement of intervertebral disc, site, without myelopathy M51.9 Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder Degeneration of cervical intervertebral disc M50.30 Other cervical disc degeneration, cervical Degeneration of thoracic or luthoracolumbar intervetebral disc Degeneration of lumbar or lumbosacral intervetebral disc Degeneration of intervertebral disc, site M50.31 Other cervical disc degeneration, high cervical M Other cervical disc degeneration, mid-cervical, level M Other cervical disc degeneration at C4-C5 level M Other cervical disc degeneration at C5-C6 level M Other cervical disc degeneration at C6-C7 level M50.33 Other cervical disc degeneration, cervicothoracic M51.34 Other intervertebral disc degeneration, thoracic M51.35 Other intervertebral disc degeneration, thoracolumbar M51.36 Other intervertebral disc degeneration, lumbar M51.37 Other intervertebral disc degeneration, lumbosacral M51.34 Other intervertebral disc degeneration, thoracic M51.35 Other intevertebral disc degeneration, thoracolumbar M51.36 Other intervertebral disc degeneration lumbar M51.37 Other intervertebral disc degeneration, lumbosacral Intervertebral disc disorder with myelopathy; M51.9 Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder Intervertebral disc disorder with myelopathy; cervical M50.00 Cervical disc disorder with myelopathy, cervical M50.01 Cervical disc disorder with myelopathy, high cervical M Cervical disc disorder with myelopathy, mid-cervical, level M Cervical disc disorder at C4-C5 level with myelopathy M Cervical disc disorder at C5-C6 level with myelopathy M Cervical disc disorder at C6-C7 level with myelopathy M50.03 Cervical disc disorder with myelopathy, cervicothoracic Intervertebral disc disorder with myelopathy; thoracic M51.04 Intervertebral disc disorders with myelopathy, thoracic M51.05 Intervertebral disc disorders with myelopathy, thoracolumbar Intervertebral disc disorder with myelopathy; lumbar M51.06 Intervertebral disc disorders with myelopathy, lumbar Post laminectomy syndrome, M96.1 Postlaminectomy syndrome, not elsewhere classified Postlaminectomy syndrome, cervical M96.1 Postlaminectomy syndrome, not elsewhere classified Postlaminectomy syndrome, thoracic M96.1 Postlaminectomy syndrome, not elsewhere classified Postlaminectomy syndrome, lumbar (failed back syndrome) M96.1 Postlaminectomy syndrome, not elsewhere classified Other and disc disorder, M46.40 Discitis,, site M51.9 Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder Other and disc disorder, cervical M50.80 Other cervical disc disorders, cervical M50.90 Cervical disorder,, cervical Other and disc disorder, thoracic M51.84 Other intervertebral disc disorder, thoracic M46.45 Discitis,, thoracolumbar M51.85 Other intervertebral disc disorder, thoracolumbar Other and disc disorder, lumbar M46.47 Discitis,, lumbosacral M51.86 Other intervertebral disc disorders, lumbar M51.87 Other intervertebral disc disorders, lumbosacral Spinal stenosis of cervical M48.01 Spinal stenosis, occipito-atlanto-axial M48.02 Spinal stenosis, cervical

5 M48.03 Spinal stenosis, cervicothoracic Cervicalgia M54.2 Cervicalgia Cervicocranial syndrome M53.0 Cerviocranial syndrome Cervicobrachnial syndrome (diffuse) M53.1 Cerviocbrachial syndrome Brachia neuritis or radiculitis NOS M54.12 Radiculopathy, cervical M54.13 Radiculopathy, cerviocothoracic Other syndromes affecting cervical M53.82 Other specified dorsopathies, cervical Unspecified musculoskeletal disorders and symptoms referable to neck M53.82 Other specified dorsopathies, cervical Spinal stenosis, M48.00 Spinal stenosis, site Spinal stenosis, thoracic M48.04 Spinal stenosis, thoracic Spinal stenosis, lumbar without neurogenic claudication M48.06 Spinal stenosis, lumbar Spinal stenosis, lumbar with neurogenic claudication M48.06 Spinal stenosis, lumbar Spinal stenosis, other M48.08 Spinal stenosis, sacral and sacrococcygeal Pain in thoracic spine M54.6 Pain in thoracic Lumbago: Low back pain, Low back syndrome, Lumbalgia M54.5 Low back pain Sciatica: Neuralgia or neuritis of sciatic nerve M54.30 Sciatica, side M54.31 Sciatica, right side M54.32 Sciatica, left side Thoracic or lumbosacral neuritis or radiculitis, M54.14 Radiculopathy, thoracic M54.15 Radiculopathy thoracolumbar M54.16 Radiculopathy lumbar M54.17 Radiculopathy lumbosacral Backache, M54.89 Other dorsalgia M54.9 Dorsalgi, Disorders of sacrum M53.3 Sacrococcygeal disorders, not elsewhere classified M53.2X7 Spinal instabilities, lumbosacral M43.27 Fusion of spine, lumbosacral M43.28 Fusion of spine, sacral and sacrococcygeal Other symptoms referrable to back M54.03 Panniculitis affecting s of neck and back, cervicothoracic M54.04 Panniculitis affecting s of neck and back, thoracic M54.05 Panniculitis affecting s of neck and back, thoracolumbar M54.06 Panniculitis affecting s of neck and back, lumbar Other back disorders Neuralgia, neuritis, and radiculitis, Pain in limb M54.07 Panniculitis affecting s of neck and back lumbosacral M54.08 Panniculitis affecting s of neck and back sacral and sacrococcygeal M53.9 Dorsopathy, M43.8X9 Other specified deforming dorsopathies, site M79.2 Neuralgia and neuritis, M54.10 Radiculopathy, site M Pain in right arm M Pain in left arm M Pain in arm, M Pain in right leg M Pain in left leg M Pain in leg, M Pain in limb M Pain in right upper arm M Pain in left upper arm M Pain in upper arm M Pain in right forearm M Pain in left forearm M Pain in forearm

6 Diabetes Secondary diabetes mellitus with neurological manifestations not stable as uncontrolled and Mononeuritis of site Diabetes with neurological manifestations and Mononeuritis of site and M Pain in right hand M Pain in left hand M Pain in hand M Pain in right finger(s) M Pain in left finger(s) M Pain in finger(s) M Pain in right thigh M Pain in left thigh M Pain in thigh M Pain in right lower leg M Pain in left lower leg M Pain in lower leg M Pain in right foot M Pain in left foot M Pain in foot M Pain in right toe(s) M Pain in left toe(s) M Pain in toe(s) and E08.41 Diabetes mellitus due to underlying condition of diabetic mononeropthay E09.41 Drug or chemical induced diabetes mellitus with neurological complications with diabetic mononeuropathy E13.41 Other specified diabetes mellitus with diabetic mononeuropathy E11.41 Type 2 diabetes mellitus with diabetic mononeuropathy E13.41 Other specified diabetes mellitus with diabetic mononeuropathy and E10.41 Type 1 diabetes mellitus with diabetic mononeuropathy Diabetes with neurological manifestations type II or type, not stated as controlled and Mononeuritis of site and Mononeuritis of site Tuberculosis of Spine Vertebral column, A18.01 Tuberculosis of spine Arthropathy associated with other bacterial diseases, other specified sites M01.X8 Direct infection of vertebrae in infectious and parasitic diseases classified elsewhere Inflammatory spondylopathies in diseases classified elsewhere M49.80 Spondylopathy in diseases classified elsewhere, site Other infections involving bone in disease classified elsewhere, other specified sites M90.88 Osteopathy in diseases classified elsewhere, other site Curvature of spine, M43.8X9 Other specified deforming dorsopathies, site Other myelopathy and disease of spinal cord Myelopathy in other diseases classified elsewhere G99.2 Myelopathy in diseases classified elsewhere Other myelopathy G95.81 Conus medullaris syndrome G95.89 Other specified diseases of spinal cord Unspecified disease of the spinal cord G95.20 Unspecified cord compression G95.29 Other cord compression G95.9 Disease of spinal cord, Other inflammatory spondylopathies Other inflammatory spondylopathies M46.50 Other infective spondylopathies, site M46.51 Other infective spondylopathies, occipito-atlanto-axial M46.52 Other infective spondylopathies, cervical M46.53 Other infective spondylopathies, cervicothoracic M46.54 Other infective spondylopathies, thoracic M46.55 Other infective spondylopathies, thoracolumbar M46.56 Other infective spondylopathies, lumbar

7 M46.57 Other infective spondylopathies, lumbosacral M46.58 Other infective spondylopathies, sacral and sacrococcygeal M46.59 Other infective spondylopathies, multiple sites in spine M46.80 Other specified inflammatory spondylopathies, site M46.81 Other specified inflammatory spondylopathies, occipitoatlanto-axial M46.82 Other specified inflammatory spondylopathies, cervical M46.83 Other specified inflammatory spondylopathies, cervicothoracic M46.84 Other specified inflammatory spondylopathies, thoracic M46.85 Other specified inflammatory spondylopathies, thoracolumbar M46.86 Other specified inflammatory spondylopathies, lumbar M46.87 Other specified inflammatory spondylopathies, lumbosacral M46.88 Other specified inflammatory spondylopathies, sacral and sacrococcygeal M46.89 Other specified inflammatory spondylopathies, multiple sites in spine Sacroiliitis, not elsewhere classified Sacroiliitis, not elsewhere classified M46.1 Sacroiliitis, not elsewhere classified Torticollis Torticollis, M43.6 Torticollis Thoracic or lumbar spondylosis with myelopathy Thoracic M47.14 Other spondylosis with myelopathy, thoracic M47.15 Other spondylosis with myelopathy, thoracolumbar Neoplasm related pain Neoplasm related pain (acute) (chronic) G89.3 Neoplasm related pain (acute) (chronic) Information provided by Nevro is presented for illustrative purposes only and does not constitute coding, reimbursement, or legal advice. It is always the provider s responsibility to determine the medical necessity and proper site of service for the procedure, and to submit appropriate codes, charges and modifiers for services rendered.

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