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v1.0.0
ICD-10 Guide
ICD-10 CodesG82.51

G82.51

Billable

Quadriplegia, C1-C4 complete

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

Code Description

ICD-10 G82.51 is a billable code used to indicate a diagnosis of quadriplegia, c1-c4 complete.

Key Diagnostic Point:

Quadriplegia, also known as tetraplegia, refers to the paralysis of all four limbs and the torso, resulting from an injury or disease affecting the spinal cord at the cervical level, specifically between C1 and C4. This condition is characterized by a complete loss of motor and sensory function below the level of injury. Individuals with C1-C4 complete quadriplegia may experience varying degrees of respiratory impairment, necessitating assistance with breathing, and may require a ventilator. The impact on mobility is profound, as these patients are often unable to perform basic activities of daily living independently. The etiology of quadriplegia can include traumatic injuries (such as those from vehicular accidents or falls), congenital conditions, or diseases like amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS). Management typically involves a multidisciplinary approach, including physical therapy, occupational therapy, and respiratory care, to optimize function and quality of life. Understanding the complexities of quadriplegia is essential for effective coding and billing, as it often intersects with various specialties and requires comprehensive documentation to support the diagnosis and treatment provided.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires precise documentation of neurological examination findings.
  • Differentiation between complete and incomplete quadriplegia.
  • Potential for co-existing conditions that may complicate coding.
  • Need for interdisciplinary collaboration in treatment documentation.

Audit Risk Factors

  • Inadequate documentation of the level of injury.
  • Failure to document associated respiratory issues.
  • Misclassification of the type of quadriplegia.
  • Lack of interdisciplinary notes supporting the diagnosis.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological assessments, including motor and sensory function evaluations.

Common Clinical Scenarios

Patients presenting with acute spinal cord injuries or progressive neurological diseases.

Billing Considerations

Documentation must clearly indicate the level of injury and completeness of paralysis.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive rehabilitation plans and progress notes detailing functional status.

Common Clinical Scenarios

Rehabilitation following spinal cord injury or stroke.

Billing Considerations

Focus on functional outcomes and interdisciplinary care coordination.

Coding Guidelines

Inclusion Criteria

Use G82.51 When
  • According to ICD
  • 10 guidelines, G82
  • 51 should be used when there is clear documentation of complete quadriplegia at the C1
  • C4 level
  • It is important to ensure that the diagnosis is supported by clinical findings and that any associated conditions are also documented

Exclusion Criteria

Do NOT use G82.51 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

97530CPT Code

Therapeutic activities

Clinical Scenario

Used in rehabilitation settings for patients with G82.51.

Documentation Requirements

Document specific therapeutic goals and progress.

Specialty Considerations

Physical therapy documentation must align with the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of quadriplegia, improving the accuracy of patient records and facilitating better care management. G82.51 provides a clear distinction for complete quadriplegia, which is crucial for treatment planning and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of quadriplegia, improving the accuracy of patient records and facilitating better care management. G82.51 provides a clear distinction for complete quadriplegia, which is crucial for treatment planning and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of quadriplegia, improving the accuracy of patient records and facilitating better care management. G82.51 provides a clear distinction for complete quadriplegia, which is crucial for treatment planning and resource allocation.

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 complete and incomplete quadriplegia?

Complete quadriplegia (G82.51) indicates total loss of motor and sensory function below the level of injury, while incomplete quadriplegia (G82.52) means there is some preserved function.