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G56.43 ICD-10-CM Code: Causalgia of bilateral upper limbs

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 073 — CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC (MDC 01)
  • MS-DRG 074 — CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC (MDC 01)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Code Overview

Causalgia of bilateral upper limbs is a billable ICD-10-CM diagnosis code (G56.43).

Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for G56.43 in the official ICD-10-CM tabular list.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Frequently Compared Codes

The official Excludes notes on G56.43 name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Causalgia of bilateral upper limbs
    FY2017 changes

Verify Before Coding

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

Other codes that name G56.43 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

5 Excludes1 notes across 2 chapters: G57.7 (via G56.4.-), G89.2 (via G56.4.-), G90.5 (via G56.4.-), M79.2 (via G56.-), M89.0 (via G56.4.-).

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 2 MS-DRGs: DRG 073 (MDC 01), DRG 074 (MDC 01).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):NVS017 — Nerve and nerve root disorders (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Nerve and nerve root disorders).

G56.21 — Lesion of ulnar nerve, right upper limb, G56.22 — Lesion of ulnar nerve, left upper limb, G56.23 — Lesion of ulnar nerve, bilateral upper limbs, G56.30 — Lesion of radial nerve, unspecified upper limb, G56.31 — Lesion of radial nerve, right upper limb, G56.32 — Lesion of radial nerve, left upper limb, G56.33 — Lesion of radial nerve, bilateral upper limbs, G56.40 — Causalgia of unspecified upper limb, G56.41 — Causalgia of right upper limb, G56.42 — Causalgia of left upper limb, G56.80 — Other specified mononeuropathies of unspecified upper limb, 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 unspecified 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, G57.00 — Lesion of sciatic nerve, unspecified lower limb, G57.01 — Lesion of sciatic nerve, right lower limb, +94 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Blood Glucose Test, Thyroid Stimulating Hormone (TSH)

Contextual Map

Every relationship of G56.43 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • G00-G99 — Chapter 6: Diseases of the Nervous System (G00-G99) (G00-G99) [Hierarchy]

Referenced by Excludes1 notes

  • G57.7 — Causalgia of lower limb [Excludes1](via G56.4.-): “complex regional pain syndrome II of upper limb (G56.4-)” · check together
  • G89.2 — Chronic pain, not elsewhere classified [Excludes1](via G56.4.-): “causalgia, upper limb (G56.4-)” · check together
  • G90.5 — Complex regional pain syndrome I (CRPS I) [Excludes1](via G56.4.-): “causalgia of upper limb (G56.4-)” · check together
  • M79.2 — Neuralgia and neuritis, unspecified [Excludes1](via G56.-): “mononeuropathies (G56-G58)” · check together
  • M89.0 — Algoneurodystrophy [Excludes1](via G56.4.-): “causalgia, upper limb (G56.4-)” · check together

Clinical classification (CCSR)

  • NVS017 — Nerve and nerve root disorders [CCSR]

Potential MS-DRG

  • DRG 073 — CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC [MS-DRG]: “CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC (MDC 01)”
  • DRG 074 — CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC [MS-DRG]: “CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC (MDC 01)”

MDC crossing · procedures (8892)

  • MDC 01 — Diseases and Disorders of the Nervous System [MDC crossing]: “Diseases and Disorders of the Nervous System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 0016070 — Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach — grouped in MDC 01, the procedure side of this code's crossing.” · check together
  • 0016071 — Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach — grouped in MDC 01, the procedure side of this code's crossing.” · check together
  • 0016072 — Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach — grouped in MDC 01, the procedure side of this code's crossing.” · check together
  • 0016073 — Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach — grouped in MDC 01, the procedure side of this code's crossing.” · check together
  • 0016074 — Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach — grouped in MDC 01, the procedure side of this code's crossing.” · check together
  • and 8887 more

Nearest codes (35)

  • G56 — Mononeuropathies of upper limb [Sibling]
  • G56.0 — Carpal tunnel syndrome [Sibling]
  • G56.00 — Carpal tunnel syndrome, unspecified upper limb [Sibling]
  • G56.01 — Carpal tunnel syndrome, right upper limb [Sibling]
  • G56.02 — Carpal tunnel syndrome, left upper limb [Sibling]
  • G56.03 — Carpal tunnel syndrome, bilateral upper limbs [Sibling]
  • G56.1 — Other lesions of median nerve [Sibling]
  • G56.10 — Other lesions of median nerve, unspecified upper limb [Sibling]
  • and 27 more

Change history

  • FY2017 — Added to the code set [Change history]

Nearest Codes in This Family

Official ICD-10-CM classifications closest to G56.43 in its code family, with their registry titles.

  • G56.33 — Lesion of radial nerve, bilateral upper limbs
  • G56.4 — Causalgia of upper limb
  • G56.40 — Causalgia of unspecified upper limb
  • G56.41 — Causalgia of right upper limb
  • G56.42 — Causalgia of left upper limb
  • G56.8 — Other specified mononeuropathies of upper limb
  • G56.80 — Other specified mononeuropathies of unspecified upper limb
  • 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

View all codes in the G56 family