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ICD-10 Guide
ICD-10 CodesG81.0

G81.0

Billable

Flaccid hemiplegia

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

Code Description

ICD-10 G81.0 is a billable code used to indicate a diagnosis of flaccid hemiplegia.

Key Diagnostic Point:

Flaccid hemiplegia is a condition characterized by weakness or paralysis affecting one side of the body, resulting from damage to the motor pathways in the brain. This condition is often seen in patients with cerebral palsy, particularly those who have sustained a brain injury during prenatal development, birth, or early childhood. The flaccid nature of the paralysis indicates a lack of muscle tone, leading to a limp appearance of the affected limbs. Patients may experience significant mobility impairments, making it difficult to perform daily activities. Flaccid hemiplegia can also be associated with other neurological conditions, such as stroke or traumatic brain injury, where the motor cortex is compromised. The severity of the condition can vary, with some individuals retaining some degree of movement or reflexes, while others may have complete loss of function on the affected side. Rehabilitation and therapy are crucial for improving mobility and function, and early intervention can lead to better outcomes.

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., spastic hemiplegia)
  • Need for comprehensive documentation to support the diagnosis
  • Potential overlap with other neurological conditions

Audit Risk Factors

  • Inadequate documentation of the neurological assessment
  • Failure to specify the affected side of the body
  • Lack of evidence for the underlying cause of hemiplegia
  • Inconsistent coding of associated conditions

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological examination findings, including motor function assessments and imaging results.

Common Clinical Scenarios

Patients presenting with sudden onset of weakness, post-stroke rehabilitation, or congenital conditions.

Billing Considerations

Ensure clarity in documenting the cause of hemiplegia and any associated neurological deficits.

Physical Medicine and Rehabilitation

Documentation Requirements

Comprehensive therapy notes detailing functional assessments and progress in rehabilitation.

Common Clinical Scenarios

Rehabilitation following stroke, traumatic brain injury, or cerebral palsy management.

Billing Considerations

Documenting the patient's functional limitations and goals for therapy is essential for accurate coding.

Coding Guidelines

Inclusion Criteria

Use G81.0 When
  • According to ICD
  • 10 coding guidelines, G81
  • 0 should be used when the clinical documentation supports a diagnosis of flaccid hemiplegia
  • It is important to include details about the affected side and any underlying conditions

Exclusion Criteria

Do NOT use G81.0 When
  • Exclusion criteria include conditions that do not involve flaccid paralysis

Related ICD-10 Codes

Related CPT Codes

97110CPT Code

Therapeutic exercises

Clinical Scenario

Used for rehabilitation of patients with flaccid 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 progress notes and functional assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like flaccid hemiplegia, improving the accuracy of patient records and facilitating better care management. It has also enhanced the ability to track outcomes and resource utilization in patients with neurological impairments.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like flaccid hemiplegia, improving the accuracy of patient records and facilitating better care management. It has also enhanced the ability to track outcomes and resource utilization in patients with neurological impairments.

Reimbursement & Billing Impact

reimbursement and should reflect the complexity of the patient's condition.

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 flaccid hemiplegia and spastic hemiplegia?

Flaccid hemiplegia is characterized by decreased muscle tone and weakness on one side of the body, while spastic hemiplegia involves increased muscle tone and stiffness. The two conditions require different management approaches and coding.