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v1.0.0
ICD-10 Guide
ICD-10 CodesG82.5

G82.5

Billable

Quadriplegia

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

Code Description

ICD-10 G82.5 is a billable code used to indicate a diagnosis of quadriplegia.

Key Diagnostic Point:

Quadriplegia, also known as tetraplegia, is a condition characterized by the paralysis of all four limbs and the torso, resulting from damage to the spinal cord or brain. This condition can arise from various causes, including traumatic injuries, congenital disorders, or diseases such as cerebral palsy. In individuals with quadriplegia, motor function is severely impaired, leading to significant mobility challenges and often requiring assistance with daily activities. The severity of quadriplegia can vary, with some individuals retaining partial movement or sensation in certain areas. The impact on quality of life can be profound, necessitating comprehensive rehabilitation and support services. Patients may also experience secondary complications such as respiratory issues, pressure sores, and urinary tract infections, which require ongoing medical management. Understanding the underlying cause of quadriplegia is crucial for effective treatment and support, as it influences the rehabilitation approach and long-term care strategies.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between complete and incomplete quadriplegia
  • Identifying the underlying cause (e.g., traumatic vs. non-traumatic)
  • Documenting associated conditions and complications
  • Understanding the impact on mobility and daily living activities

Audit Risk Factors

  • Inadequate documentation of the extent of paralysis
  • Failure to document associated conditions
  • Misclassification of the type of quadriplegia
  • Lack of clarity in the cause of the condition

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Detailed neurological assessments, imaging results, and functional status evaluations.

Common Clinical Scenarios

Patients with traumatic spinal cord injuries, degenerative diseases, or congenital conditions leading to quadriplegia.

Billing Considerations

Neurologists must document the specific neurological deficits and any changes in the patient's condition over time.

Rehabilitation Medicine

Documentation Requirements

Comprehensive rehabilitation plans, progress notes, and assessments of functional abilities.

Common Clinical Scenarios

Patients undergoing rehabilitation post-injury or surgery to improve mobility and independence.

Billing Considerations

Rehabilitation specialists should document the patient's goals, therapy interventions, and outcomes to support coding.

Coding Guidelines

Inclusion Criteria

Use G82.5 When
  • According to ICD
  • 10 coding guidelines, G82
  • 5 should be used when documenting quadriplegia resulting from various causes
  • Coders must ensure that the documentation supports the diagnosis and includes any relevant details about the patient's functional status and associated conditions

Exclusion Criteria

Do NOT use G82.5 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 quadriplegia to improve functional mobility.

Documentation Requirements

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

Specialty Considerations

Rehabilitation specialists should ensure that therapy goals align with the patient's functional needs.

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. The detailed coding options enable healthcare providers to capture the complexity of the condition more effectively.

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. The detailed coding options enable healthcare providers to capture the complexity of the condition more effectively.

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. The detailed coding options enable healthcare providers to capture the complexity of the condition more effectively.

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 quadriplegia and paraplegia?

Quadriplegia involves paralysis of all four limbs, while paraplegia affects only the lower limbs. The coding and management of these conditions differ significantly due to the extent of paralysis.