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v1.0.0
ICD-10 Guide
ICD-10 CodesG81.9

G81.9

Billable

Hemiplegia, unspecified

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

Code Description

ICD-10 G81.9 is a billable code used to indicate a diagnosis of hemiplegia, unspecified.

Key Diagnostic Point:

Hemiplegia refers to paralysis affecting one side of the body, typically resulting from damage to the brain, often due to stroke, traumatic brain injury, or other neurological conditions. In cases of cerebral palsy, hemiplegia can manifest as a result of brain injury during fetal development or early childhood. Patients may experience significant mobility impairments, affecting their ability to walk, perform daily activities, and maintain independence. The severity of hemiplegia can vary widely, with some individuals retaining partial movement and others experiencing complete paralysis on one side. This condition can also lead to secondary complications such as muscle stiffness, joint deformities, and difficulties with coordination and balance. Accurate diagnosis and coding are essential for appropriate treatment planning and resource allocation, as well as for understanding the broader implications of mobility impairments on quality of life.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of hemiplegia
  • Differentiation from other types of paralysis (e.g., paraplegia, quadriplegia)
  • Need for comprehensive documentation of neurological assessments
  • Potential overlap with other neurological conditions

Audit Risk Factors

  • Inadequate documentation of neurological assessments
  • Failure to specify the cause of hemiplegia
  • Misclassification of hemiplegia as other types of paralysis
  • Lack of supporting evidence for mobility impairments

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 congenital conditions leading to hemiplegia.

Billing Considerations

Ensure clarity in documenting the onset and progression of symptoms to support the diagnosis.

Physical Medicine and Rehabilitation

Documentation Requirements

Functional assessments, rehabilitation goals, and progress notes.

Common Clinical Scenarios

Rehabilitation of patients post-stroke or those with cerebral palsy requiring mobility aids.

Billing Considerations

Document the impact of hemiplegia on daily living activities and the need for assistive devices.

Coding Guidelines

Inclusion Criteria

Use G81.9 When
  • According to ICD
  • 10 guidelines, G81
  • 9 should be used when hemiplegia is present but the specific cause is not documented
  • Coders should ensure that the documentation supports the diagnosis and that any underlying conditions are also coded appropriately

Exclusion Criteria

Do NOT use G81.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

97110CPT Code

Therapeutic exercises

Clinical Scenario

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

Documentation Requirements

Documentation of the patient's baseline functional status and progress notes.

Specialty Considerations

Physical therapy notes should clearly outline the goals of therapy and patient response.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hemiplegia, enabling better tracking of patient outcomes and resource utilization. G81.9 provides a broad classification that can be refined with additional codes for underlying conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hemiplegia, enabling better tracking of patient outcomes and resource utilization. G81.9 provides a broad classification that can be refined with additional codes for underlying conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of hemiplegia, enabling better tracking of patient outcomes and resource utilization. G81.9 provides a broad classification that can be refined with additional codes for underlying conditions.

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 partial weakness on one side. Both conditions can arise from similar neurological causes but differ in severity.