Traumatic Brachial Plexopathy F104

Current RMA Instruments

Changes from previous Instruments

ICD Coding

ICD-10-AM Code: G54.1                  

Brief description

Traumatic brachial plexopathy involves a physical injury to the brachial plexus, the network of nerves originating from the spinal cord that controls movement and sensation in the shoulders, arms, and hands. Brachial plexus syndromes are rare, and often the cause is trauma. This condition results in varying degrees of pain and functional impairment.

There is some overlap between these SoPs for traumatic brachial plexopathy and the SoPs for thoracic outlet syndrome. Therefore, it is important to ensure the most correct SoP applies for the case involved. 

Confirming the diagnosis

The diagnosis is made from clinical evaluation, with imaging (often MRI) and other tests such as electromyography (EMG) and nerve conduction studies (NCS) generally required for confirmation.

To establish this diagnosis, the assessment and/or management may involve consultation with the following medical specialists: neurologists, neurosurgeons, and/or orthopaedic surgeons.

Additional diagnoses covered by SOP

• Brachial plexus injury
• Traumatic brachial plexus neuropathy
• Traumatic brachial plexus syndrome
• Brachial plexus neuritis
• Traumatic plexopathy
• Brachial plexus trauma
• Brachial plexus palsy 

Diagnoses not covered by SOP

• Parsonage- Turner syndrome (neuralgic amyotrophy) #
• Radiation induced plexus injury #
• Thoracic outlet syndrome *
• Cervical radiculopathy or myelopathy * Peripheral neuropathy SoP, Cervical spondylosis SoP or #
• Upper limb mononeuritis multiplex * Peripheral neuropathy SoP

* another SOP applies  - the SOP has the same name unless otherwise specified

^# non-SOP condition

Clinical onset

This condition typically has an acute onset, as there is often a sudden and forceful injury to the brachial plexus involved. The symptoms and signs will depend on the type and mechanism of trauma.  However, there can be motor symptoms (weakness or paralysis in the shoulder, arm or hand), sensory symptoms, pain or physical deformity. 

Once the diagnosis has been confirmed, clinical onset can be dated to the onset of the first clinical event or presentation that is judged by a treating medical specialist to be related to the condition.

Clinical worsening

This outcomes for this condition can vary widely, depending on the severity, location and mechanism of injury. Some individuals can respond well to treatment (conservative or surgical) but some may develop a chronic course and permanent disability. The same factors that can cause the condition can worsen this condition. Permanent worsening would be evidenced by uncontrolled pain, signs of permanent nerve damage, progressive upper extremity weakness and severe disability. Evidence of clinical worsening beyond the normal course of the condition is required and seeking advice from treating specialists would be recommended.