2027 ICD-10-CM Diagnosis Code G90.519Complex regional pain syndrome I of unspecified upper limb

ICD-10-CM Codes›G00–G99›G89-G99›G90

ICD-10-CM G90.519
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

G90.519 is a billable ICD-10-CM diagnosis code for complex regional pain syndrome I of unspecified upper limb. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 73 through 74. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 156 closely related codes. The code is flagged as an unspecified code, since codes identifying laterality exist in the same family. Coders also document this condition as complex regional pain syndrome of hand. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Nervous system pain and pain syndromes.

G90.519 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model. It still risk-adjusts in the ESRD (V21) category 75 for payment year 2027.

Code Identity

ICD-10-CM Code
G90.519
Billable Status
Yes — Valid for Submission
Code Describes
Complex regional pain syndrome I of unspecified upper limb
Short Description
Complex regional pain syndrome I of unspecified upper limb
Same as the full description in the CMS dataset.
Parent Code
G90.51
Complex regional pain syndrome I of upper limb

Code Classification

ChapterG00–G99Diseases of the nervous system
SectionG89-G99Other disorders of the nervous system
CategoryG90Disorders of autonomic nervous system
This CodeG90.519Complex regional pain syndrome I of unspecified upper limb

Code EditsBilling

Medicare Code Editor checks that affect claim validity for G90.519.

Unspecified codes
Unspecified codes exist in the ICD-10-CM classification for circumstances when documentation in the medical record does not provide the level of detail needed to support reporting a more specific code. However, in the inpatient setting, there should generally be very limited and rare circumstances for which the laterality (right, left, bilateral) of a condition is unable to be documented and reported. The following pages contain the list of unspecified ICD-10-CM diagnosis codes for which there is a more specific code to identify laterality (right, left, bilateral) within that code family.

Medicare Risk Adjustment (HCC)Billing

G90.519 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model, but it maps to payment categories in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
no payment category in the model that pays 100% of MA risk scores
Prior Model (CMS-HCC V24)
Not mapped under V24
this diagnosis newly risk-adjusts under the V28 model
Other CMS Models
ESRD (V21): HCC 75
ESRD V21 weights: 0.059 dialysis, 0.284–0.323 functioning graft
Part D (RxHCC)
Not mapped
G90.519 does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Complex regional pain syndrome of hand
  • Complex regional pain syndrome of upper limb

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to G90.519: its own notes plus those printed at G90.5, G90, and Chapter 6. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From G90.5 Complex regional pain syndrome I (CRPS I) applies to 10 codes
  • causalgia of lower limb (G57.7-)
  • causalgia of upper limb (G56.4-)
  • complex regional pain syndrome II of lower limb (G57.7-)
  • complex regional pain syndrome II of upper limb (G56.4-)
From G90 Disorders of autonomic nervous system applies to 21 codes
  • dysfunction of the autonomic nervous system due to alcohol (G31.2)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Chapter 6 (G00-G99) Diseases of the nervous system applies to 700 codes
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name G90.519, its category, or a range that includes it.

Excludes1 6

These codes carry an Excludes1 note naming G90.519: they are not reported together with it, unless the two conditions are unrelated.

  • G56.4 Causalgia of upper limb
    complex regional pain syndrome I of upper limb (G90.51-) names G90.51-, which includes this code
  • G56.4 Causalgia of upper limb
    reflex sympathetic dystrophy of upper limb (G90.51-) names G90.51-, which includes this code
  • G57.7 Causalgia of lower limb
    complex regional pain syndrome I of upper limb (G90.51-) names G90.51-, which includes this code
  • G57.7 Causalgia of lower limb
    reflex sympathetic dystrophy of upper limb (G90.51-) names G90.51-, which includes this code
  • G89.2 Chronic pain, not elsewhere classified
    reflex sympathetic dystrophy (G90.5-) names G90.5-, which includes this code
  • M89.0 Algoneurodystrophy
    reflex sympathetic dystrophy (G90.5-) names G90.5-, which includes this code

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR NVS019
Nervous system pain and pain syndromes
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Complex Regional Pain Syndrome I

    a neurologic condition characterized by burning pain, tenderness, swelling, and changes in the skin color and temperature of a body part or extremity that has no identifiable nerve injury; most pediatric patients present with this form.

Patient EducationClinical

Complex Regional Pain Syndrome

Complex regional pain syndrome (CRPS) is a chronic pain condition. It causes intense pain, usually in the arms, hands, legs, or feet. It may happen after an injury, either to a nerve or to tissue in the affected area. Rest and time may only make it worse.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert G90.519 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
337.21 Rflx sym dystrph up limb
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About G90.519Overview

What is the ICD-10 code for complex regional pain syndrome I of unspecified upper limb?

The ICD-10-CM code for complex regional pain syndrome I of unspecified upper limb is G90.519 (sometimes written as G90519). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is G90.519 (Complex regional pain syndrome I of upper limb) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report complex regional pain syndrome I of unspecified upper limb on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does G90.519 group to?

When complex regional pain syndrome I of unspecified upper limb is the principal diagnosis on an inpatient stay, it groups to MS-DRG 74, 73, with relative weights from 1.0172 to 1.5773 depending on complications. Higher weights mean higher Medicare reimbursement.

Is G90.519 a CC or MCC?

CMS lists G90.519 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 156 closely related codes in its exclusion list.

Can G90.519 be reported with a code from G57.7?

Not as a rule. The Excludes1 note at G90.5, which applies to G90.519, lists "causalgia of lower limb (G57.7-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

Does G90.519 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage: G90.519 maps to no category in the CMS-HCC V28 model. It still risk-adjusts in the ESRD (V21) category 75 (Polyneuropathy).