Current RMA Instruments

Changes from previous Instruments

SOP Bulletin 177

ICD Coding

• ICD-9-CM Codes: 337.0. 337.9, 354.5, 357.1 – 357.9
• ICD-10-AM Codes: G58.7, G62, G63, G90

Brief description

The term peripheral neuropathy can be used to describe any disorder of the peripheral nervous system, i.e. those nerves outside the brain and spinal cord.  This can include polyneuropathy (a relatively homogeneous process affecting many peripheral nerves), radiculopathy (a compressed nerve in the spine causing problems along the course of the nerve) and mononeuropathy (focal involvement of a single nerve).  Peripheral neuropathy can involve sensory, motor or autonomic nervous functioning. The SOP covers polyneuropathies and some other specific conditions, but not radiculopathies or isolated mononeuropathies.

Confirming the diagnosis

This SOP covers some but not all of the disorders of the peripheral nerves.  Before applying the SOP, check that the claimed condition is not one of the many neuropathies excluded from this SOP (see list, below).  Generally for the SOP to apply the disorder must involve multiple peripheral nerves.

Diagnosis usually requires specific electrodiagnostic testing. 

The appropriate medical specialist is a neurologist.

Additional diagnoses covered by SOP

• Peripheral autonomic neuropathy
• Mononeuritis multiplex
• Polyneuropathy

Conditions not covered by SOP

• Amyotrophic lateral sclerosis* - motor neuron disease SOP
• Bell’s palsy^#, ICD code 351.0
• Brachial plexopathy^#, ICD code 353.0
• Carpal tunnel syndrome*
• Cauda equina syndrome^#
• Cerebrovascular accident*
• Charcot-Marie-Tooth disease*
• Congenital neuropathies^#
• Cranial nerve disorders, ICD codes 350, 351, 352, 377, 378, 388.5
• Guillian-Barré syndrome*
• Hereditary neuropathies^#
• Intercostal neuropathies^#, ICD code 354.8
• Lumbosacral plexopathy^#, ICD code 353.1
• Meralgia paraesthetica^#, ICD code 355.1
• Mononeuropathies, ICD codes 354.0-4, 354.8, 354.9, 355
• Morton’s metatarsalgia/neuralgia/neuroma*
• Motor neuron disease*
• Multiple sclerosis*
• Muscle disorders^#
• Myasthenia gravis*
• Myelitis^#
• Myelopathy^#
• Myopathies^#
• Nerve root disorders, ICD code 353.2-4
• Neuromuscular disorders^#
• Periodic limb movement disorder*
• Plexopathy^#
• Radiculopathy
• Restless legs syndrome*
• Sciatica, ICD code 724.3
• Trigeminal neuralgia*
• Trigeminal neuropathy*
• Ulnar nerve neuropathy* (SOP pending)

* another SOP applies

^# non-SOP condition

Clinical onset

The nature of the clinical onset depends on the type or neuropathy and the cause of the condition.  Onset may be sudden or gradual.  A common presentation is a distal, symmetric sensory loss, burning, or weakness in the lower limbs.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  Appropriate management varies but may involve treatment of any underlying disease, cessation of exposure to any triggering substance and alleviation of symptoms.  Consideration of whether there has been worsening beyond the normal course of the condition will generally require specialist medical opinion.