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Disability Code For Carpal Tunnel?

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vaf

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Vicki: I don't know if any of these are what you are looking for, but they all have something concerning the wrist. Evidently their isn't just one code to us in rating for Carpal Tunnel.

http://ecfr.gpoaccess.gov/cgi/t/text/text-...idno=38;cc=ecfr

http://frwebgate.access.gpo.gov/cgi-bin/ge...ON=45&TYPE=TEXT

http://www.vba.va.gov/bln/21/Benefits/exams/disexm27.htm

http://www.vba.va.gov/bln/21/Benefits/exams/disexm34.htm

Jim S. :P

Edited by Jim S.
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  • HadIt.com Elder

Vicki

This is probably what you want:

5307 Group VII. Function: Flexion of wrist and

fingers. Muscles arising from internal condyle

of humerus: Flexors of the carpus and long

flexors of fingers and thumb; pronator..........

Severe....................................... 40 30

Moderately Severe............................ 30 20

Moderate..................................... 10 10

Slight....................................... 0 0

5308 Group VIII. Function: Extension of wrist,

fingers, and thumb; abduction of thumb. Muscles

arising mainly from external condyle of humerus:

Extensors of carpus, fingers, and thumb;

supinator.......................................

Severe....................................... 30 20

Moderately Severe............................ 20 20

Moderate..................................... 10 10

Slight....................................... 0 0

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Carpal Tunnel is caused by a nerve dysfynction.

The median nerve

8515 Paralysis of:

Complete; the hand inclined to the ulnar side, the 70 60

index and middle fingers more extended than

normally, considerable atrophy of the muscles of

the thenar eminence, the thumb in the plane of the

hand (ape hand); pronation incomplete and

defective, absence of flexion of index finger and

feeble flexion of middle finger, cannot make a

fist, index and middle fingers remain extended;

cannot flex distal phalanx of thumb, defective

opposition and abduction of the thumb, at right

angles to palm; flexion of wrist weakened; pain

with trophic disturbances..........................

Incomplete:

Severe............................................ 50 40

Moderate.......................................... 30 20

Mild.............................................. 10 10

8615 Neuritis.

8715 Neuralgia.

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  • HadIt.com Elder

This is extracted from Chap 61 Common Hand Disorders,of the Merck Manual, under Section 5, Musculoskeletal & Connective Tissue Disorders.

CARPAL TUNNEL SYNDROME

Compression of the median nerve as it passes through the carpal tunnel in the wrist.

Carpal tunnel syndrome is very common and most commonly occurs in women aged 30 to 50 yr. Causes include RA (sometimes the presenting manifestation), diabetes mellitus, hypothyroidism, acromegaly, amyloidosis, and pregnancy (producing edema in the carpal tunnel). Activities or jobs that require repetitive flexion and extension of the wrist (eg, keyboard use) may pose an occupational risk. Often, no underlying cause is found.

Symptoms and Diagnosis

Symptoms include pain of the hand and wrist associated with tingling and numbness, classically distributed along the median nerve (the palmar side of the thumb, the index and middle fingers, and the radial half of the ring finger) but possibly involving the entire hand. Typically, the patient wakes at night with burning or aching pain and with numbness and tingling and shakes the hand to obtain relief and restore sensation.

Diagnosis is indicated by a positive Tinel's sign, in which the tingling (paresthesia) is reproduced by tapping with a reflex hammer at the volar surface of the wrist over the site of the median nerve and carpal tunnel. Additional tests include wrist flexion maneuvers (eg, Phalen's sign). Thenar atrophy and weakness on thumb elevation may develop late. Diagnosis is confirmed by electrodiagnostic testing of median nerve conduction velocity, which provides an accurate index of motor and sensory nerve conduction.

Treatment

Treatment includes a lightweight wrist splint, especially at night; possibly pyridoxine (vitamin B6) 50 mg bid; and mild analgesics (eg, acetaminophen, NSAIDs). Some persons find relief by changing the position of computer keyboards and making other ergonomic corrections. If these measures fail to control symptoms, a corticosteroid should be locally injected into the carpal tunnel at a site just ulnar to the palmaris longus tendon and proximal to the distal crease at the wrist. If bothersome symptoms persist or recur or if hand weakness and thenar wasting progress, surgical decompression of the carpal tunnel using an open technique or endoscopy is recommended.

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  • HadIt.com Elder

David,

There is no code for pain alone, it is supposed to be factored in to range of motion ratings, or other ratings that can include pain, as a significant problem.

Check out the 5200 series, and 8510.

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