What is the ICD-10 (International Classification of Diseases, 10th Revision) code for numbness in hands and fingers?

ICD-10 Code for Numbness in Hands and Fingers

The appropriate ICD-10 code for numbness in hands and fingers is R20.2 (Paresthesia of skin), which covers numbness, tingling, and altered sensation in the extremities. 1

Primary Coding Options

• R20.2 (Paresthesia of skin) is the most commonly used code for numbness and tingling sensations in the hands and fingers when no underlying cause has been identified 1
• R20.0 (Anesthesia of skin) can be used if there is complete loss of sensation rather than altered sensation 2
• R20.8 (Other disturbances of skin sensation) serves as an alternative when the presentation doesn't fit typical paresthesia patterns 2

Coding Based on Underlying Etiology

When a specific cause is identified, code the underlying condition instead of or in addition to the symptom code:

• G56.00-G56.03 for carpal tunnel syndrome (unilateral or bilateral) causing median nerve distribution numbness 2
• G56.20-G56.23 for ulnar nerve entrapment causing numbness in the fourth and fifth fingers 2
• G62.9 for unspecified polyneuropathy when bilateral symmetric numbness suggests a systemic neuropathy 2
• G63 for polyneuropathy in diseases classified elsewhere (such as diabetic neuropathy coded as E11.42 for type 2 diabetes with diabetic polyneuropathy) 2

Clinical Assessment to Guide Coding Specificity

Determine the pattern of numbness by asking about distribution (bilateral symmetric versus unilateral, specific nerve territories versus diffuse), associated symptoms (pain, weakness, burning), and timing (constant versus intermittent) 1, 2

Test both small-fiber function (pinprick and temperature) and large-fiber function (vibration and 10-g monofilament) to characterize the type of sensory loss 2

Consider nerve conduction studies when the pattern suggests mononeuropathy (like carpal tunnel) versus polyneuropathy, as this determines whether to use a specific nerve entrapment code versus a generalized neuropathy code 2

Common Coding Pitfalls

• Avoid using unspecified codes when more specific information is available - the trend toward using unspecified codes increased 108.5% with ICD-10-CM implementation despite greater specificity being available 3
• Don't code symptoms when the underlying diagnosis is known - if carpal tunnel syndrome is confirmed, use G56.00-G56.03 rather than R20.2 2, 4
• Include laterality when codes require it - many nerve entrapment codes distinguish between right (ending in 1), left (ending in 2), bilateral (ending in 3), or unspecified side (ending in 0) 2
• Add secondary codes for contributing factors such as vitamin B12 deficiency, hypothyroidism, or diabetes when these conditions contribute to the neuropathy 2

Documentation Requirements

Record the specific location (which fingers, unilateral versus bilateral, proximal versus distal hand involvement) to support code selection 4

Document any identified underlying causes including metabolic conditions, toxin exposures, medication effects, or structural nerve compression to justify moving from symptom codes to diagnostic codes 2, 4

Update coding as the diagnostic workup progresses - initial encounters may appropriately use R20.2, but subsequent encounters after diagnostic testing should use more specific codes when etiologies are identified 4