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ICD-10 Guide
ICD-10 CodesChapter 6: Diseases of the nervous systemG81

G81

Billable

Hemiplegia and hemiparesis

Chapter 6:Diseases of the nervous system

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 G81 is a billable code used to indicate a diagnosis of hemiplegia and hemiparesis.

Key Diagnostic Point:

Hemiplegia and hemiparesis refer to conditions characterized by weakness (hemiparesis) or complete paralysis (hemiplegia) affecting one side of the body. These conditions can arise from various neurological disorders, including stroke, traumatic brain injury, or cerebral palsy. In children, hemiplegia is often associated with cerebral palsy, a group of disorders affecting movement and muscle tone due to brain damage during development. Hemiplegia can lead to significant mobility impairments, affecting daily activities and quality of life. Patients may experience difficulties with coordination, balance, and fine motor skills. Rehabilitation strategies often include physical therapy, occupational therapy, and assistive devices to enhance mobility and independence. The severity of hemiplegia can vary widely, with some individuals retaining partial movement and others experiencing complete loss of function on the affected side. Accurate coding is essential for appropriate treatment planning and reimbursement, as well as for tracking outcomes in clinical practice.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between hemiplegia and hemiparesis
  • Identifying the underlying cause (e.g., stroke, cerebral palsy)
  • Documenting the affected side (right or left)
  • Understanding associated conditions (e.g., spasticity, contractures)

Audit Risk Factors

  • Inadequate documentation of the affected side
  • Failure to specify the cause of hemiplegia/hemiparesis
  • Incorrect coding of severity (e.g., acute vs. chronic)
  • Lack of supporting clinical evidence for the diagnosis

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with stroke, traumatic brain injury, or progressive neurological disorders.

Billing Considerations

Ensure clear documentation of the onset, duration, and progression of symptoms.

Pediatrics

Documentation Requirements

Developmental assessments, family history, and details of any associated conditions.

Common Clinical Scenarios

Children diagnosed with cerebral palsy or post-infectious neurological conditions.

Billing Considerations

Documenting developmental milestones and interventions is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use G81 When
  • According to ICD
  • 10 guidelines, G81 should be used when hemiplegia or hemiparesis is confirmed
  • Coders must ensure that the documentation supports the diagnosis, including the affected side and any underlying conditions

Exclusion Criteria

Do NOT use G81 When
  • Exclusion criteria include conditions that do not meet the definition of hemiplegia or hemiparesis

Related CPT Codes

97110CPT Code

Therapeutic exercises

Clinical Scenario

Used for rehabilitation of patients with hemiplegia to improve strength and mobility.

Documentation Requirements

Document the specific exercises performed and the patient's response.

Specialty Considerations

Physical therapy documentation should include goals and progress notes.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hemiplegia and hemiparesis, improving the accuracy of data collection and reimbursement processes. The granularity of codes helps in tracking outcomes and tailoring rehabilitation strategies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hemiplegia and hemiparesis, improving the accuracy of data collection and reimbursement processes. The granularity of codes helps in tracking outcomes and tailoring rehabilitation strategies.

Reimbursement & Billing Impact

reimbursement processes. The granularity of codes helps in tracking outcomes and tailoring rehabilitation strategies.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between hemiplegia and hemiparesis?

Hemiplegia refers to complete paralysis of one side of the body, while hemiparesis indicates weakness on one side. Both conditions can result from similar underlying causes, but the severity of motor impairment differs.