30 April 2020

David Lawson
[FYI request #12433 email]

Tēnā koe David

Your Official Information Act request, reference: GOV-004164
Thank you for your request of 11 March 2020, asking for the following information under the Official
Information Act 1982 (the Act):

OIA 1982 Request 1
Please confirm whether ACC accepts complex regional pain syndrome (CRPS) injuries for cover
under the ACC Act 2001, and any of the ACC Act's previous versions.

OIA 1982 Request 2
If the answer to OIA 1982 Request 1 above is yes, please advise when ACC first accepted claims
for CRPS.

OIA 1982 Request 3
If the answer to OIA 1982 Request 1 above is yes, please confirm what the ACC Read Code is for
complex regional pain syndrome (CRPS) is and all variants further denoting such things as: (1)
the area of of the body the CRPS applies to, (the type of CRPS that applies) * Please refer to the
CRPS ICD 10 Codes for CRPS sourced from http://www.rsdhope.org/icd-10-codes-for-crps.html
included at the bottom of the page.

OIA 1982 Request 4
If the answer to request OIA 1982 Request 1 is yes, please advise if and when the ACC Read
Codes that ACC treatment providers use to lodge specific injury code diagnoses with the
Corporation were updated to include the injury diagnosis complex regional pain syndrome, and
expanded to include all sub codes in line with the ICD classification diagnosis codes.

OIA 1982 Request 5
If ACC does not have comparative Read Codes for CRPS and all it's sub diagnosis codes in line
with the ICD yearly diagnosis codes, how has a claimant's CRPS injury been registered as an
injury on EOS on a claimant's claim file as a diagnosis code?. . i.e. so what recognised diagnosis
code or codes for CRPS are used to provide an updated diagnosis of complex regional pain
syndrome on a claimants EOS claim file.

Does ACC record CRPS as CRPS on a clients clain records on EOS or does ACC use a different
medical term to register a CRPS injury diagnosis on a claimants EOS claim file. If so please use
the medical diagnosis term that ACC has previously and currently use for updating a claimants
CRPS injury code on their EOS file.

Request 1
ACC can accept claims for cover for complex regional pain syndrome (CRPS).

                                                                                                                                                   GOV-004164

Request 2
ACC is unable to locate any documentation (including policy directives) around when it began to accept
claims for CRPS. As such, it is not possible to specifically identify a date when ACC first started accepting
claims for CRPS. Therefore, we are refusing this part of your request under section 18(e) of the Act, as
the information does not exist or cannot be found.

Our data team has been able to identify from our electronic claim records dating back to 2002, that the
earliest claim lodged with ACC which has a CRPS code (below) associated with it was lodged in 1978.

Please note:
•  that an injury code can be added to claim when it is lodged with ACC or at a later date
•  the above data was extracted on 2 April 2020.

Requests 3 and 5
ACC uses several codes for CRPS, including ICD (International Classification of Diseases) and Read codes.
The ICD10 codes are:
•  G5811 - complex regional pain syndrome upper limb
•  G5812 – complex regional pain syndrome lower limb
The Read codes are:
•  F344 – Causalgia
•  N337 – Algoneurodystrophy
•  N3371 – Sudek’s atrophy
•  N3372 – Algodystrophy of hand
•  N3373 – Algodystrophy of knee
•  N3374 – Algodystrophy of foot

There wil  be instances where clients are receiving entitlements in relation to CRPS, but these
entitlements are not associated with one of the read codes listed above. This includes instances where a
client has cover for another physical injury (such as a fracture) or an alternative diagnosis was used
describing pain more generally.

Request 4
Read and ICD codes are lists of international y recognised codes developed and updated by external
agencies, which are used to identify injuries and diagnoses. The ICD codes have been in development by
the World Health Organisation since 1949 and have been used international y and in New Zealand.

ACC is not responsible for the development or update of Read codes or ICD codes: we only apply them
to claims where the claim information supports the corresponding diagnosis.

Background information about coding injuries and diagnoses on ACC claims
When an ACC45 injury claim form is lodged with ACC the health provider assigns the relevant Read code
or ICD code to the injury/diagnosis. However, in instances where the health provider is unsure about
what code to use, the form is lodged with a Z- Read code and the health provider includes a written
description of the symptoms/injury so ACC can assign an appropriate code. More information about
Read codes and ICD codes can be found on the Lodging claims page on ACC’s website, here:
www.acc.co.nz/for-providers/lodging-claims/.

How to contact us
If you have any questions, you can email me at [email address].

Accident Compensation Corporation
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GOV-004164

If you are not happy with this response, you have the right to make a complaint to the Ombudsman.
Information about how to do this is available at www.ombudsman.parliament.nz or by phoning 0800
802 602.

Nāku iti noa, nā

Sasha Wood
Manager Official Information Act Services
Government Engagement & Support
Accident Compensation Corporation
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