Help With Rating Codes

david walker · May 9, 2006

Got the results of my EMG. Any idea what codes they will use to rate?

1. median neuropathy - wrist (CTS)

2. ulnar neropathy elbow

3. chronic bilateral c6-t1 cervical radiculopathy in bilateral upper extremity

May 9, 2006

Diseases of the Peripheral Nerves

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Rating

Schedule of ratings -----------------

Major Minor

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The term ``incomplete paralysis,'' with this and other

peripheral nerve injuries, indicates a degree of lost

or impaired function substantially less than the type

picture for complete paralysis given with each nerve,

whether due to varied level of the nerve lesion or to

partial regeneration. When the involvement is wholly

sensory, the rating should be for the mild, or at

most, the moderate degree. The ratings for the

peripheral nerves are for unilateral involvement;

when bilateral, combine with application of the

bilateral factor.

Upper radicular group (fifth and sixth cervicals)

8510 Paralysis of:

Complete; all shoulder and elbow movements lost or 70 60

severely affected, hand and wrist movements not

affected...........................................

Incomplete:

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

Moderate.......................................... 40 30

Mild.............................................. 20 20

8610 Neuritis.

8710 Neuralgia.

Middle radicular group

8511 Paralysis of:

Complete; adduction, abduction and rotation of arm, 70 60

flexion of elbow, and extension of wrist lost or

severely affected..................................

Incomplete:

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

Moderate.......................................... 40 30

Mild.............................................. 20 20

8611 Neuritis.

8711 Neuralgia.

Lower radicular group

8512 Paralysis of:

Complete; all intrinsic muscles of hand, and some or 70 60

all of flexors of wrist and fingers, paralyzed

(substantial loss of use of hand)..................

Incomplete:

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

Moderate.......................................... 40 30

Mild.............................................. 20 20

8612 Neuritis.

8712 Neuralgia.

All radicular groups

8513 Paralysis of:

Complete............................................ 90 80

Incomplete:

Severe............................................ 70 60

Moderate.......................................... 40 30

Mild.............................................. 20 20

8613 Neuritis.

8713 Neuralgia.

The musculospiral nerve (radial nerve)

8514 Paralysis of:

Complete; drop of hand and fingers, wrist and 70 60

fingers perpetually flexed, the thumb adducted

falling within the line of the outer border of the

index finger; can not extend hand at wrist, extend

proximal phalanges of fingers, extend thumb, or

make lateral movement of wrist; supination of hand,

extension and flexion of elbow weakened, the loss

of synergic motion of extensors impairs the hand

grip seriously; total paralysis of the triceps

occurs only as the greatest rarity.................

Incomplete:

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

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

Mild.............................................. 20 20

8614 Neuritis.

8714 Neuralgia.

Note: Lesions involving only ``dissociation of extensor communis

digitorum'' and ``paralysis below the extensor communis digitorum,''

will not exceed the moderate rating under code 8514.

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.

The ulnar nerve

8516 Paralysis of:

Complete; the ``griffin claw'' deformity, due to 60 50

flexor contraction of ring and little fingers,

atrophy very marked in dorsal interspace and thenar

and hypothenar eminences; loss of extension of ring

and little fingers cannot spread the fingers (or

reverse), cannot adduct the thumb; flexion of wrist

weakened...........................................

Incomplete:

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

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

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

8616 Neuritis.

8716 Neuralgia.

OnRiver · May 9, 2006

could you please give a link to the chart you give....also I have been diagnosed by the VA with peripherial neurapathy plus dsyenthias and parenthesis of the hands etc. There is also more listed than just sensory loss that other losses which I can't remember now also occured. Does this move it into the medium or does it stay in the mild and if so how does the numbers actually change. Also how does one figure the "bilateral factor" Sorry I am really new to this. Thanks for your time and concern.

Frank