G56.4 vs G57
G56.4 and G57 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on G56.4
complex regional pain syndrome II of lower limb (G57.7-)
G56.4
Causalgia of upper limb
Not billable
- Chapter 6
- Diseases of the nervous system
- Section
- G50-G59
Use when the record says
- Complex regional pain syndrome II of upper limb
Indexed under
- Causalgia (upper limb)
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027