For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM. Idiopathic small fiber peripheral neuropathy; Neuropathy (nerve damage), hereditary sensory; Notalgia paresthetica; Dominantly inherited sensory neuropathy; Morvan's disease; Nelaton's syndrome; Recessively inherited sensory neuropathy. malignant carcinoid tumors of the small intestine (C7A. This pathology may be the result of metabolic, toxic, immune-mediated, and/or genetic factors. Sometimes, this could already be present at the time of diagnosis for type 2 diabetes mellitus (T2DM), while it appears in subjects with type 1 diabetes mellitus (T1DM) almost 10 years after the onset of the disease. Neuropathy in association with hereditary ataxia. 9 is a billable diagnosis code used to specify polyneuropathy, unspecified. While granulomatous nerve involvement is rare in sarcoidosis, SFN is reported in over 40% of. 43 [convert to ICD-9-CM]Results: All 3 cases showed marked improvement in pain scores. It discusses the possible mechanisms, diagnosis, and management of these rare but serious adverse events. In a large retrospective cohort, autoantibodies against TS-HDS and FGFR3 were reported in 28% and 17% of individuals with small fiber neuropathy, respectively. 4 at the calf. 2 - Neuropathy in diabetes: Combination Flag - Multiple codes are needed to describe the source. The authors suggested that sensory neuropathy was due to small and large fiber dysfunction, a finding that in agreement with other studies 17. 013 [convert to ICD-9-CM]. ICD-10 codes covered for indications. Z13. The ratings under DC 8520 range from 80 to 10 percent: Search Results ; M79. Inclusion or exclusion of a code does. The pattern of neuropathy is different for polyneuropathy caused by direct HIV infection, which affects all fibers, compared with that induced by antiretroviral treatment, which affects small fibers. Retinal nerve fiber layer myelinated; ICD-10-CM H47. Small fiber neuropathy (SFN) is a type of peripheral neuropathy that occurs from damage to the small A-delta and C nerve fibers that results in the clinical condition known as SFN. The patient is not diabetic. 89) at VCUHS . Short description: Sjogren syndrome with peripheral nervous system involvement. Unlike many of the other peripheral neuropathies, vasculitic neuropathy can be. Test number copied. 9, 357. Nondiabetic peripheral neuropathy. Klassifikation nach ICD-10; G62 Sonstige Neuropathien G62. Patients suffer from neuropathic pain, usually according to a length-dependent pattern []. 001) and lower ESC on the feet ( p < 0. 2 Neuropathy in association with hereditary ata. 8:. Small fiber neuropathy (SFN) is a disorder of the thinly myelinated Aδ-fibers and the unmyelinated C-fibers, with a minimum prevalence of 53/100,000 []. 8 percent to 64 percent. Showing 1-25: ICD-10-CM Diagnosis Code G60. Objective: To Identify Small Fiber Neuropathy (SFN) as Cause of Autonomic Dysfunction and/or Pain/Sensory Dysfunction in Children Background: Small fiber neuropathy remains under-recognized in children and underdiagnosed. Idiopathic small fiber peripheral neuropathy; Neuropathy (nerve damage), hereditary sensory; Notalgia paresthetica; Dominantly inherited sensory neuropathy; Morvan's disease; Nelaton's syndrome; Recessively inherited sensory neuropathy. This section shows you chapter-specific coding guidelines to increase your understanding and correct usage of the target ICD-10-CM Volume 1 code. G56. Charcot marie tooth disease; Charcot marie tooth disease, type 1; Charcot. 0 became effective on. This is the American ICD-10-CM version of L40. 2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. ICD-10-CM Diagnosis Code G58. This is the American ICD-10-CM version of G60. Small fiber neuropathy was assessed using SudoScan (a 3-min test). ICD-10-CM Diagnosis Code G62. This is the American ICD-10-CM version of G60. 2016. 8 - other international versions of ICD-10 G62. Overview of polyneuropathy. This is the American ICD-10-CM version of G57. Almost all individuals with TS-HDS and/or. The morbidity in the group of patients with idiopathic SFN with or without large fiber involvement was high: more than 80% of the 29 patients had continuous neuralgic. Small fiber neuropathy (SFN) is caused by damage to the small, unmyelinated fibers in the peripheral nerves that innervate the skin and internal organs, including the cardiovascular system, gastrointestinal tract, and bladder, among others. Hereditary and idiopathic neuropathy (G60) Other hereditary and idiopathic neuropathies (G60. 0 - other international versions of ICD-10 G60. Encounter for screening for other nervous system disorders. Search Page 7/20: small fiber neuropathy Search Results 500 results found. ICD-10-CM Diagnosis Code G60. 0): 123 Neurological eye disorders; Convert H47. Objective: The development and persistence of neurological symptoms following SARS-CoV-2 infection is referred to as “long-haul” syndrome. Small Fiber Neuropathy or Autonomic Neuropathy. The affected nerve fibers are the small-diameter myelinated A-delta fibers and unmyelinated C fibers, which mediateSmall fiber neuropathy can be idiopathic or associated with underlying diseases (e. 89 may differ. 2 A specific SFN ICD-10 diagnostic code (G628) has been. 9 should not be billed as it is not valid code. E78. Small fibre neuropathy was diagnosed at baseline of the validation study in 149 of 352 patients (42. 89 - other international versions of ICD-10 G61. 1. 8 should only be used for claims with a date of service on or before September 30, 2015. Other symptoms of small fiber neuropathy include: a tingling or prickling sensation. Neuropathy is an abnormal and usually degenerative state of the nervous system or nerves. Idiopathic small fiber peripheral neuropathy. Unspecified injury to L2 level of lumbar spinal cord. to April 2009 at the Department of Neurophysiology at Karolinska University Hospital was searched for the diagnosis code. Physical exam noted dry skin and colour change. Sometimes small fiber neuropathy may be associated with either partial or global autonomic failure and this can be detected through autonomic testing. Familial amyloid neuropathy, finnish type. 8 [convert to ICD-9-CM] Other hereditary and idiopathic neuropathies. In: Cleveland Clinic Journal of Medicine. The advent of epidermal skin biopsies and PGP 9. ICD-10-CM Diagnosis Code H30. Foot drop, left foot. 099. The average reduction in pain was 54%. 7, 3. Etiology remains unknown in most patients for the same reasons. Background: Post COVID-19 “long-haul” syndrome. 6% for men and 8. Of these, TS-HDS and FGFR-3 cases were identified, and clinical features and treatment responses were analyzed. 43 [convert to ICD-9-CM]Other hereditary and idiopathic neuropathies. Since SFN may be the only symptom of late-onset Fabry disease, it may be underdiagnosed in patients with idiopathic polyneuropathy. 4%) based on the combination between two clinical signs and abnormal QST and IENFD (69. Neuropathy: ICD codes: Fracture: Y: 30–40-fold increase in hospitalization rate for hip fracture with DPN. Boruchow SA, Gibbons CH. We recorded sensory symptoms and signs and evaluated presence and severity of neuropathic pain according to the Douleur. 0 - E03. Jun 19, 2019. Autonomic neuropathy; Hereditary or idiopathic neuropathy; Hereditary peripheral neuropathy; Idiopathic peripheral neuropathy; Neuropathy (nerve damage), autonomic;. 3 to 16. 2 may differ. In total, 211 unique medical record. G60. The 2024 edition of ICD-10-CM G60. 001) with 14% fulfilling the criteria for neuropathic pain elevated VPT ( p < 0. Small fiber peripheral neuropathy is a type of peripheral neuropathy that occurs from damage to the small unmyelinated and myelinated peripheral nerve fibers. 8 is grouped within Diagnostic Related Group (s) (MS-DRG v41. 43 [convert to ICD-9-CM] Other hereditary and idiopathic neuropathies. 240 results found. G60. ICD-10-CM Diagnosis Code T82. 81 [convert to ICD-9-CM] Other specified mononeuropathies of right upper limb. Oct 02, 2021 · Axonal Neuropathy. [ Read More ] Regarding Billing. Convert to ICD-10-CM: 356. Here, we aim to study the role of small fiber neuropathy (SFN) underlying neuropathic symptoms associated with COVID-19 infection. 89 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The data is not an. 2 . Latov and colleagues identified that environmental sources may play a role in idiopathic axonal and small fiber neuropathy (see below) (48). Small fibre neuropathy was diagnosed at baseline of the validation study in 149 of 352 patients (42. G62. E11. Small fibre neuropathy was ruled out in 5 of 150 patients (3. Neuropathic syndromes are common complications of diabetes mellitus. According to the Chinese diabetes epidemiological survey, the total prevalence of diabetes and the prevalence of prediabetes are 9. Type 2 diabetes mellitus with diabetic neuropathy, unsp;. Megavitamin-B 6 syndrome is predominately a large fiber neuropathy characterized by sensory loss of joint position, vibration and ataxia. 90:. 89 contain annotation back-references that may be applicable to G61. 0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 89 became effective on October 1, 2023. It is due to the involvement of A-delta and C nerve fibers. The ICD code G628 is used to code Small fiber peripheral neuropathy. Our study shows the interest of skin biopsy, Laser Evoked Potentials, Quantitative Sensory Testing and Electrochemical Skin Conductance measurement for the diagnosis of Small Fiber Neuropathy. [ Read More ] Regarding Billing. e. Office: (682) 323-5904 FAX: (682) 323-4139Codes. 23 [convert to ICD-9-CM] Postherpetic polyneuropathy. Mod. 224. 8 [convert to ICD-9-CM] Other hereditary and idiopathic neuropathies Idiopathic small fiber peripheral neuropathy; Neuropathy (nerve damage), hereditary sensory; Notalgia paresthetica; Dominantly inherited sensory neuropathy; Morvan's disease; Nelaton's syndrome; Recessively inherited sensory neuropathy G62. Small fiber neuropathy typically involves distal degeneration of small or unmyelinated nerve fibers. View in. Peripheral neuropathy is a condition of the peripheral nervous system, which consists of nerves outside the brain and spinal cord. A detailed history of symptoms, family and occupational history should be obtained. Skin biopsy can diagnose such a small-fiber neuropathy and is a surrogate marker of DRG neuronal cell loss. 0; Poisoning by heavy metal anti-infectives: 961. 9. 0 - E03. A day that changed my world forever. Search Results. The presenting symptoms, acuity, time course, severity, and subsequent morbidity vary and depend on the type of fiber. 3 - other international versions of ICD-10 G60. The 2024 edition of ICD-10-CM M35. G60. The nerves that make. 9 is a billable diagnosis code used to specify polyneuropathy, unspecified. The etiology of small fiber neuropathy (SFN) often remains unclear. The other thing to keep in mind is that G62. . Charcot-Marie-Tooth disease; Déjérine-Sottas disease; Hereditary motor and sensory neuropathy, types I-IV; Hypertrophic neuropathy of infancyNeuropathy in PD. 8. 3. Intercostal neuralgia; Neuralgia, intercostal; Neuropathy (nerve damage), intercostal nerve. Skin biopsy can also identify the underlying cause of small fiber neuropathy when concurrent conditions such as diabetes mellitus emerge (Hoeijmakers. 2 Neuropathy in association with hereditary ataxia. The lab that performs the pathological component of this test has told him that we will bill with the biopsy codes 11100-11101. FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. (PEXPD), primary erythromelalgia, small fiber neuropathy; hereditary sensory and autonomic neuropathy type 5 (HSAN5) hereditary sensory and autonomic neuropathy type 6 (HSAN6) hereditary sensory and autonomic neuropathy type 7 (HSAN7), familial episodic pain syndrome type 3 (FEPS3). G60 Hereditary and idiopathic neuropathy. 8. It goes away on its own in some cases. This is the American ICD-10-CM version of G62. 858 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 0 - E00. Other hereditary and idiopathic neuropathies. 9 is an. documented as type 2 diabetes mellitus with diabetic neuropathy (E11. The 2024 edition of ICD-10-CM G62. Prevalence of sensory and motor neuropathy with HCV was found to be 9% and 10% respectively. I am thinking this is unspecified peripheral neuropathy--G92. 10. Substance P and antagonists of the neurokinin-1 receptor in neuroinflammation associated with infectious and neurodegenerative diseases of the central nervous system. ICD-10-CM Diagnosis Code. [1] It is the most common cause of outpatient neurology appointments in the United States and accounts for healthcare spending of over $10 billion each year. 372. . Showing 26-50: ICD-10-CM Diagnosis Code H93. The 2024 edition of ICD-10-CM G60. ICD-10-CM Diagnosis Code E26. These included 63% (10/16) of skin biopsies, 17% (2/12) of electrodiagnostic tests and 50% (4/8) of autonomic function tests. 9 ICD-9 code for Small Fiber Neuropathy: 356. TABLE 1 Features of small fiber neuropathy Sensations vary in quality and time Patients with small fiber neuropathy typically present with a symmetric length. Immunoglobulin therapy has been used increasingly with significant efficacy in the treatment of patients with disabling autoimmune forms of dysautonomia, which are most often small fiber (autonomic and/or sensory) polyneuropathies. 2018;10:1179573518771703. 43 [convert to ICD-9-CM] Other hereditary and idiopathic neuropathies. 3 - other international versions of ICD-10 G60. FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. Lattice corneal dystrophy. Background: Post COVID-19 “long-haul” syndrome include chronic fatigue, brain fog, sleep disturbance and paraesthesias. G62. 000 and 53/100. Diabetes mellitus is a worldwide pandemic, affecting 537 million adults 1 (37. 89 is a billable diagnosis code used to specify a medical diagnosis of other specified polyneuropathies. I agree with Thomas' answer 100%. 40 (DM with. III-2: Miao et al. 89 - other international versions of ICD-10 G62. 9. For instance, Charcot-Marie-Tooth (CMT) disease, one of the most common types of hereditary neuropathies, affects the motor and sensory nerves. Background. Peripheral neuropathy, which typically results in weakness, numbness, and discomfort in the hands and feet, is caused by injury to the nerves external to the brain and spinal cord [ 5 ]. Search All ICD-10 Toggle Dropdown. ICD-10-CM Diagnosis Code H46. 856. The other thing to keep in mind is that G62. 6,10,11,19,20 In series of patients with sensory-only neuropathy or small fiber neuropathy, the most common symptoms are pain in 54% to. G62. It goes away on its own in some cases. Small fiber neuropathy is diagnosed clinically but has traditionally been a diagnosis of exclusion based on clinical findings and the absence of large fiber involvement, as determined by. This is the American ICD-10-CM version of G62. The 2024 edition of ICD-10-CM G61. (DRG). 3 may differ. 4%). 3 Idiopathic progressive neuropathy. The device measures the ESC of the hands and feet expressed in microSiemens (µS). Just one study focussed on the prevalence of small fibre neuropathy, in which amongst 98 patients, 45 patients had large fibre peripheral neuropathy and 37 patients (37. SFN is associated with conditions like diabetes mellitus and autoimmune diseases, but in 53% of the patients, the etiology remains unknown. Based on the description from the PCP, another unspecified neuropathy diagnosis needs to be billed. Scholz J, Finnerup NB, Attal N, Aziz Q, Baron R, Bennett MI, et al. 9 and some say it should be to neuralgia codes. The presentation can involve pain, suggesting small fiber involvement and includes motor nerve involvement too in up to 50% in some samples [ 7 ]. 3 [convert to ICD-9-CM] Idiopathic progressive neuropathy. The drawback of this study, however, is that the diagnosis of small fibre neuropathy was only made via QST, which is a. ICD-10-CM Diagnosis Code M89. The drawback of this study, however, is that the diagnosis of small fibre neuropathy was only made via QST, which is a. Peripheral nerve disorders in sarcoidosis consist of granulomatous neuropathy and non-granulomatous small fiber neuropathy (SFN), which differ in their underlying pathology, diagnostic methods and treatment. 3%) of the reappraisal study. Under ICD-9 CM guidelines - look at 357. bladder. Sensory predominant symmetrical polyneuropathy involves perivascular infiltration of lymphocytes and monocytes of small sized vessels. Idiopathic small fiber peripheral neuropathy; Neuropathy (nerve damage), hereditary sensory; Notalgia paresthetica; Dominantly inherited sensory neuropathy; Morvan's disease; Nelaton's syndrome; Recessively inherited sensory neuropathySearch Results. Other hereditary and idiopathic neuropathies. Of hospital discharges between 2005 and 2010 among those age ≥18 years, 7. 001) compared to control participants. . The peripheral nervous system is not located in the brain or spine. • Distal small fiber neuropathy • Postural tachycardia syndrome • Reflex sympathetic dystrophy (e. ICD-10-CM Diagnosis Code E09. 9 ?. 2022 Jan;65 (1):10-28. 82 became effective on October 1, 2023. Particularly relevant to neurologic practice is the detection of postganglionic sudomotor. Idiopathic small fiber peripheral neuropathy; Neuropathy (nerve damage), hereditary sensory; Notalgia paresthetica; Dominantly inherited sensory neuropathy; Morvan's disease; Nelaton's syndrome; Recessively inherited sensory neuropathy. Objective: The development and persistence of neurological symptoms following SARS-CoV-2 infection is referred to as “long-haul” syndrome. ICD-10-CM Diagnosis Code E10. 6%), sensorimotor axonal neuropathy in seven patients (50%), and a normal result in three patients (21. However, not all patients with small fiber neuropathy have autonomic involvement, so a test that will assess the somatic fibers may be quite useful. Ischemic optic neuropathy, bilateral. The 2024 edition of ICD-10-CM G56. Search All ICD-10; ICD-10-CM Diagnosis Codes; ICD-10-PCS Procedure Codes; ICD-10-CM Diagnosis Index; ICD-10-CM External Causes Index; ICD-10-CM Table of Drugs; ICD-10-CM Table of Neoplasms; HCPCS Codes; ICD-9-CM Diagnosis Codes; ICD-9-Vol-3 Procedure Code; Search All DataType 2 diabetes mellitus with diabetic neuropathy, unspecified. Competent medical evidence indicates that the veteran has peripheral neuropathy as a result of exposure to Agent Orange in Vietnam. Peripheral neuropathy is a common manifestation of AL amyloidosis, and the incidence of peripheral neuropathy in AL amyloidosis varies from 9. J Cent Nerv Syst Dis. These are nerves that arise directly from the brain and affect movement and sensation in the eyes and face. Idiopathic small fiber peripheral neuropathy; Neuropathy (nerve damage), hereditary sensory; Notalgia paresthetica; Dominantly inherited sensory neuropathy; Morvan's disease; Nelaton's syndrome; Recessively inherited sensory neuropathy. 00 - E11. Browse all the diagnosis codes used for hereditary and. Sep 4, 2009. Synonyms: abdominal neuropathy, aplasia of muscle, autosomal dominant optic atrophy. g. 9 Hereditary and idiopathic neuropathy, unspecified . Idiopathic small fiber peripheral neuropathy; Neuropathy (nerve damage), hereditary sensory; Notalgia paresthetica;. Incomplete mild paralysis: 10 percent. #2. Sensory modes affected equivalently. Synonyms: abdominal neuropathy, aplasia of muscle, autosomal dominant optic atrophy. This is the American ICD-10-CM version of G60. To evaluate distressing symptoms in a patient with a clinical picture suspicious for distal small fiber neuropathy in order to diagnose the condition. 9 [convert to ICD-9-CM] Hereditary and idiopathic neuropathy, unspecified. 0 [convert to ICD-9-CM] Intercostal neuropathy. Other hereditary and idiopathic neuropathies. Incomplete moderate paralysis: 20 percent. 1 The typically painful nature of symptoms, autonomic involvement, and lack of data surrounding clinical features and outcomes can be distressing for both patients and providers, reducing quality of life. 06 became effective on October 1, 2023. 3 may differ. . ICD-10-CM Diagnosis Code E10. 82 Radiation-induced polyneuropathy. G60. Objective This is the first double-blind randomized controlled trial evaluating the efficacy and safety of IV immunoglobulin (IVIG) vs placebo in patients with idiopathic small fiber neuropathy (I-SFN). The symptoms of vasculitic neuropathy depend on the type and location of the nerve fiber involved. 500 results found. The ICD-10-CM code G62. 8% had an International Classification of Diseases, Ninth Revision (ICD-9), code of Diabetes with Neurological Manifestations, and 4. Hoffman et al 10 evaluated the validity of different polyneuropathy codes among a general population and reported a PPV for DPN of 91% for the ICD-9 code “polyneuropathy in diabetes” 357. The acute immune-mediated polyneuropathies are classified under the eponym Guillain-Barré syndrome (GBS), a heterogeneous group of conditions with several variant forms (see "Guillain-Barré syndrome in adults: Pathogenesis, clinical features, and diagnosis" ). Synonyms. 8: Other hereditary and idiopathic neuropathies: ICD-10 codes not covered for indications listed in the CPB (not all-inclusive): E00. Typically, it affects the lower extremities. Showing 26-50: ICD-10-CM Diagnosis Code C17. 51. An early systematic analysis of autonomic dysfunction following COVID-19 is lacking and may provide initial insights into the spectrum of this condition. Idiopathic peripheral autonomic neuropathy; Peripheral autonomic neuropathy, idiopathic; Idiopathic peripheral autonomic neuropathy NOS. The etiology of small fiber neuropathy (SFN) often remains unclear. ICD-10-CM Diagnosis Code G60. ICD-10-CM Diagnosis Code G90. G62. ICD-10 codes covered if selection criteria are met: G60. Just curious, what are you all coding for "neuropathic pain"? I've seen some coders use G62. 89 contain annotation back-references that may be applicable to G61. 09 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Although the term “diabetic neuropathy” encompasses a broad spectrum of different neuropathic. 500 results found. 52 - other international versions of ICD-10 L40. 601. 0 : Guillain-Barre syndrome : 75 G61. Considerations for diagnosis and treatment of small fiber neuropathies. As PDN is due to small-fiber injury, the 10 g monofilament pressure test as well as the standard electrophysiological procedures may be normal. We therefore aimed to characterize patients with SFN and Sjögren’s syndrome to raise awareness of this disease and facilitate its early recognition as an essential step for appropriate treatment. 8 [convert to ICD-9-CM] Other hereditary and idiopathic neuropathies. Although multiple causes of small nerve fibre degeneration have been reported, including via genetic mutations, the cause of small fibre neuropathy remains unknown in up to 50% of cases. 256 results found. 3 Toxic optic neuropathy . 06 became effective on October 1, 2023. , 2012). Peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system, which is a vast communications network that sends signals between the central nervous system (the brain and spinal cord) and all other parts of the body. not defined as CIAP) Ho 2009: Idiopathic small fiber neuropathy (i. 9 became effective on October 1, 2023. 9 – other international versions of ICD-10 G62. Get crucial instructions for accurate ICD-10-CM G62. ” Estimates suggest that at least 2% of the. 9--uncovered by Medicare. 1 The prevalence in the general population may be as. Other hereditary and idiopathic neuropathies. 10) Codes. 001) and hands ( p < 0. Hereditary neuropathies can have similar symptoms. The majority of patients experience sensory disturbances. Diabetic neuropathy is one of the most prevalent chronic complications in adults with type 1 or type 2 diabetes while also affecting individuals with prediabetes and young people with diabetes, with an estimated lifetime prevalence exceeding 50% (1–4). ICD10: G62. Small fiber symptoms can be variable and inconsistent and therefore require an objective biomarker confirmation. 06 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. e. 8 [convert to ICD-9-CM] Other hereditary and idiopathic neuropathies. The other thing to keep in mind is that G62. The neuropathy was non-length-dependent in 89%, and classified as SNN in 64%, non-length-dependent small fiber neuropathy in 17% and other mostly nonlength-dependent sensory neuropathy in 19%. It is found in the 2022 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2021 – Sep 30, 2022 . skin biopsy is evaluation of small fiber sensory neuropathy (Smith & Gibson, 2022). 89 Other specified polyneuropathies. Idiopathic small fiber peripheral neuropathy. Small fiber neuropathy in diabetes polyneuropathy: is it time to change? J Diabetes Sci Technol (2022) 16:321–31. 0. The gold standard for small-fiber neuropathy is assessment of intra-epidermal nerve fiber density measurements by skin punch biopsy. g.