Hemiplegia and hemiparesis
In Cerebral palsy and other paralytic syndromes (G80-G83), chapter 6: Diseases of the Nervous System
15 billable codes under G81: all are a CC; all map to HCC 253 (Hemiplegia/Hemiparesis).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.
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Instructional notes
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
- Section I.C.6.a Dominant/nondominant side (page 45), covers G81
For G81 and G83.1 to G83.3, when the side is documented but dominance is not: right side defaults to dominant, left side to nondominant, and ambidextrous patients to dominant.
Other Chapter 6 topics:
- Pain - Category G89 (page 45)
All codes under G81
G81 can't be used on a claim. Pick a billable code below; grey headings group them.
- G81.0Flaccid hemiplegia
- G81.00Flaccid hemiplegia affecting unspecified side
- G81.01Flaccid hemiplegia affecting right dominant side
- G81.02Flaccid hemiplegia affecting left dominant side
- G81.03Flaccid hemiplegia affecting right nondominant side
- G81.04Flaccid hemiplegia affecting left nondominant side
- G81.1Spastic hemiplegia
- G81.10Spastic hemiplegia affecting unspecified side
- G81.11Spastic hemiplegia affecting right dominant side
- G81.12Spastic hemiplegia affecting left dominant side
- G81.13Spastic hemiplegia affecting right nondominant side
- G81.14Spastic hemiplegia affecting left nondominant side
- G81.9Hemiplegia, unspecified
- G81.90Hemiplegia, unspecified affecting unspecified side
- G81.91Hemiplegia, unspecified affecting right dominant side
- G81.92Hemiplegia, unspecified affecting left dominant side
- G81.93Hemiplegia, unspecified affecting right nondominant side
- G81.94Hemiplegia, unspecified affecting left nondominant side
G81 MS-DRGs
As the principal diagnosis, all 15 billable codes under G81 group to MS-DRG 056 or 057 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Paralysis
Paralysis is the loss of muscle function in part of your body. It happens when something goes wrong with the way messages pass between your brain and muscles. Paralysis can be complete or partial. It can occur on one or both sides of your body. It can also occur in just one area, or it can be widespread. Paralysis of the lower half of your body, including both legs, is called paraplegia. Paralysis of the arms and legs is quadriplegia.
Read more about paralysis on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.
