ICD-10 G56.4
Non-Billable HeaderCausalgia of upper limb
About ICD-10-CM G56.4
ICD-10-CM code G56.4 represents Causalgia of upper limb. This is a non-billable header code in the Nervous System chapter (block G56). The 2026 edition of ICD-10-CM G56.4 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under G56.4. Per CMS ICD-10-CM Tabular 2026.
- Complex regional pain syndrome II of upper limb
Type 1 Excludes
Pure excludes, these codes can never be coded together with G56.4. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- complex regional pain syndrome I of lower limb (G90.52-)
- complex regional pain syndrome I of upper limb (G90.51-)
- complex regional pain syndrome II of lower limb (G57.7-)
- reflex sympathetic dystrophy of lower limb (G90.52-)
- reflex sympathetic dystrophy of upper limb (G90.51-)
Medicare LCD Coverage for G56.4
Local Coverage Determinations (LCDs) from CMS MACs that list G56.4 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing G56.4.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but G56.4 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with G56.4
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To G56.4
Other codes in section G50-G59 (Nerve, nerve root and plexus disorders).
ICD-10 G56.4, Billing FAQ
Is ICD-10 code G56.4 billable? +
No, G56.4 is a non-billable header code. Use a more specific child code from block G56 when submitting claims.
What other names or terms map to G56.4? +
ICD-10 G56.4 includes: Complex regional pain syndrome II of upper limb.
What codes are Type 1 Excludes for G56.4? +
Type 1 Excludes (never code together with G56.4): complex regional pain syndrome I of lower limb (G90.52-); complex regional pain syndrome I of upper limb (G90.51-); complex regional pain syndrome II of lower limb (G57.7-)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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