ICD-10 G90.5
Non-Billable HeaderComplex regional pain syndrome I (CRPS I)
About ICD-10-CM G90.5
ICD-10-CM code G90.5 represents Complex regional pain syndrome I (CRPS I). This is a non-billable header code in the Nervous System chapter (block G90). The 2026 edition of ICD-10-CM G90.5 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 G90.5. Per CMS ICD-10-CM Tabular 2026.
- Reflex sympathetic dystrophy
Type 1 Excludes
Pure excludes, these codes can never be coded together with G90.5. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- 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-)
Medicare LCD Coverage for G90.5
Local Coverage Determinations (LCDs) from CMS MACs that list G90.5 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 G90.5.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but G90.5 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with G90.5
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 G90.5
Other codes in section G89-G99 (Other disorders of the nervous system).
ICD-10 G90.5, Billing FAQ
Is ICD-10 code G90.5 billable? +
No, G90.5 is a non-billable header code. Use a more specific child code from block G90 when submitting claims.
What other names or terms map to G90.5? +
ICD-10 G90.5 includes: Reflex sympathetic dystrophy.
What codes are Type 1 Excludes for G90.5? +
Type 1 Excludes (never code together with G90.5): causalgia of lower limb (G57.7-); causalgia of upper limb (G56.4-); 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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