2025 ICD-10-CM Diagnosis Code S65

Specific Coding Applicable to Injury of blood vessels at wrist and hand level

Non-specific codes like S65 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for injury of blood vessels at wrist and hand level:

Coding Guidelines

The appropriate 7th character is to be added to each code from block Injury of blood vessels at wrist and hand level (S65). Use the following options for the aplicable episode of care:

• A - initial encounter
• D - subsequent encounter
• S - sequela

Patient Education

Hand Injuries and Disorders

No matter how old you are or what you do for a living, you are always using your hands. When there is something wrong with them, you may not be able to do your regular activities.

Hand problems include :

• Carpal tunnel syndrome - compression of a nerve as it goes through the wrist, often making your fingers feel numb
• Injuries that result in fractures (broken bones), ruptured ligaments and dislocations
• Osteoarthritis - wear-and-tear arthritis, which can also cause deformity
• Tendinitis - irritation of the tendons
• Disorders and injuries of your fingers and thumb

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Peripheral Nerve Disorders

What are peripheral nerves?

Nerves are like wires that carry messages back and forth between your brain and your body. Your peripheral nerves branch off from your brain and spinal cord and connect to all parts of your body, including your muscles and organs. Peripheral nerves carry messages from your brain that control your movement, breathing, heartbeat, digestion, and more. They also carry messages from your body to your brain, so you can feel things, such as pain, heat, and cold.

What are peripheral nerve disorders?

Peripheral nerve disorders happen when one or more peripheral nerves are damaged. Damaged nerves may not carry messages correctly, or they may not work at all. As a result, you may have pain, trouble walking, or a variety of other problems, depending on which nerves are involved.

Peripheral nerve disorders are very common. There are more than 100 different types.

What causes peripheral nerve disorders?

Many things can damage nerves and lead to peripheral nerve disorders:

• Diabetes is the most common cause of peripheral nerve disorders. Most people with diabetes will develop diabetic nerve problems.
• Physical injury (trauma) that stretches, crushes, squeezes, cuts, or puts pressure on one or more nerves. Some examples of peripheral nerve disorders from physical injury include complex regional pain syndrome and brachial plexus injuries.
• Health conditions, including:
  • Certain cancers and their treatment (chemotherapy and radiation therapy).
  • Infections, such as HIV and Lyme disease.
  • Problems with blood or blood vessels.
  • Autoimmune diseases, such as rheumatoid arthritis and lupus.
  • Kidney or liver disease.
• Certain medicines.
• Contact with certain toxic substances, such as lead or mercury.
• Alcohol use disorder (AUD) and smoking.
• Vitamin imbalances, especially a lack of vitamin B12.
• Your genes, including changes in your genes or conditions that you inherit from your parents, such as Charcot-Marie-Tooth disease.

In certain cases, the cause of peripheral nerve disorder is not known.

What are the symptoms of peripheral nerve disorders?

The symptoms of peripheral nerve disorders depend on which nerves are affected, what is causing the damage, and how serious it is:

Types of nerves	Possible symptoms of nerve damage
Motor nerves control your muscles and all your movement, such as walking, talking, and using your hands.	Weak or aching muscles Problems with balance, walking, or using your arms and hands Cramps or twitching muscles Muscle shrinking
Sensory nerves carry messages to your brain from your senses, including touch, hot and cold, and pain.	Tingling, numbness, or pain often in the hands and feet Not being able to feel heat, cold, or pain, such as a cut on your foot Pain from even light touch
Autonomic nerves send messages to your organs to control breathing, digestion, and other body functions that happen without thinking about them.	A heartbeat that's too fast or too slow Trouble swallowing Sweating too much or too little Vomiting, diarrhea, or constipation Problems with urination or sexual function

Symptoms may range from mild to very strong. They may develop quickly over days or slowly over months and years. But they are rarely life-threatening.

How are peripheral nerve disorders diagnosed?

To find out if you have a peripheral nerve disorder, your provider will:

• Ask about your medical history
• Ask about your family health history
• Do a physical exam
• Order tests, which may include:
  • Blood tests
  • Genetic tests
  • Nerve tests that measure:
    • Electrical activity in your nerves and muscles
    • How well your autonomic nerves are working
  • A biopsy of nerve or skin tissue
  • CT or MRI scan to see what may be pressing on your nerves

What are the treatments for peripheral nerve disorders?

It's important to treat any conditions that are causing nerve damage. In certain cases, that will allow your nerves to heal over time.

Treatment for symptoms depends on the type of peripheral nerve disorder you have, where it is, and how severe. Treatment options include:

• Braces or splints
• Over-the-counter patches and skin creams
• Prescription medicines
• Non-drug pain management, such as electrical stimulation or relaxation therapy
• Surgery to relieve pressure on a nerve

Can peripheral nerve disorders be prevented?

You can help prevent peripheral nerve disorders by:

• Managing health conditions that may cause nerve damage, especially diabetes
• Preventing falls and accidents
• Avoiding toxic substances
• Being careful to avoid repeated motions and body positions that press on your nerves
• Eating a balanced diet, exercising, limiting alcohol, and not smoking

NIH: National Institute of Neurological Disorders and Stroke

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Wrist Injuries and Disorders

Your wrist connects your hand to your forearm. It is not one big joint; it has several small joints. This makes it flexible and allows you to move your hand in different ways. The wrist has two big forearm bones and eight small bones known as carpals. It also has tendons and ligaments, which are connective tissues. Tendons connect muscles to bones. Ligaments connect bones to each other.

What are the types of wrist injuries and disorders?

Some of the more common types of wrist injuries and disorders are:

• Carpal tunnel syndrome, which happens when a nerve that runs from your forearm into your palm becomes squeezed at the wrist
• Ganglion cysts, which are noncancerous lumps or masses
• Gout, which is a form of arthritis caused by a buildup of uric acid in your joints
• Fractures (broken bones)
• Osteoarthritis, the most common type of arthritis. It is caused by wear and tear of the joints.
• Sprains and strains, which are injuries to ligaments and injuries to muscles or tendons
• Tendinitis, inflammation of a tendon, usually due to overuse

Who is at risk for wrist injuries and disorders?

Certain things can put you at higher risk of having a wrist problem, including:

• Doing sports, which can put you at risk for injuries and puts stress on your wrist. For example, you may fall on your outstretched hand when you are skating or snowboarding. Your wrist could be injured while doing contact sports. And other sports such as gymnastics and basketball can strain your wrists.
• Doing repetitive wrist motions, such as typing on a keyboard, working on an assembly line, or using power tools.
• Having certain diseases. For example, rheumatoid arthritis can cause wrist pain.

What are the symptoms of wrist injuries and disorders?

The symptoms of a wrist problem can vary, depending on the problem. A common symptom is wrist pain. Some other possible symptoms include swelling, a decrease in wrist strength, and sudden numbness or tingling.

How are wrist injuries and disorders diagnosed?

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• A physical exam, including checking your wrist strength and range of motion
• An x-ray or other imaging test
• Blood tests

What are the treatments for wrist injuries and disorders?

Treatments for wrist pain depends on the type of injury or disorder. They may include:

• Resting your wrist
• Wearing a wrist brace or cast
• Pain relievers
• Cortisone shots
• Physical therapy
• Surgery

Can wrist injuries and disorders be prevented?

To try to prevent wrist problems, you can:

• Use wrist guards, when doing sports that put you at risk for wrist injuries
• In the workplace, perform stretching exercises and take frequent rest breaks. You should also pay attention to ergonomics to make sure that you are using the proper wrist position while working.
• Make sure that you get enough calcium and vitamin D to keep your bones strong

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Code History

• FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.