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v1.0.0
ICD-10 Guide
ICD-10 CodesG83.5

G83.5

Billable

Locked-in state

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

Code Description

ICD-10 G83.5 is a billable code used to indicate a diagnosis of locked-in state.

Key Diagnostic Point:

Locked-in state is a neurological condition characterized by complete paralysis of voluntary muscles in all parts of the body except for vertical eye movements and blinking. This condition typically results from damage to the brainstem, often due to stroke, traumatic brain injury, or diseases such as amyotrophic lateral sclerosis (ALS). Patients with locked-in syndrome are fully conscious and aware of their surroundings but are unable to speak or move, leading to significant communication challenges. The condition can be confused with other forms of paralysis, such as quadriplegia or cerebral palsy, but it is distinct in that cognitive function remains intact. Management of locked-in state often involves rehabilitation therapies aimed at improving communication and mobility, as well as supportive care to address the patient's needs. Understanding the nuances of this condition is crucial for accurate coding and appropriate treatment planning.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating locked-in state from other forms of paralysis.
  • Need for detailed documentation of neurological assessments.
  • Potential for co-existing conditions that complicate coding.
  • Variability in patient presentation and communication abilities.

Audit Risk Factors

  • Inadequate documentation of neurological assessments.
  • Misclassification of the condition as a different type of paralysis.
  • Failure to document the patient's communication abilities.
  • Lack of interdisciplinary notes that support the diagnosis.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Comprehensive neurological evaluations, including cognitive assessments and communication abilities.

Common Clinical Scenarios

Patients presenting with sudden onset of paralysis, often following a stroke or traumatic injury.

Billing Considerations

Neurologists must ensure that all aspects of the patient's condition are documented, including any co-morbidities.

Rehabilitation Medicine

Documentation Requirements

Detailed therapy notes outlining the patient's progress and communication strategies.

Common Clinical Scenarios

Patients undergoing rehabilitation to improve communication and mobility post-injury.

Billing Considerations

Rehabilitation specialists should document the effectiveness of interventions and any changes in the patient's condition.

Coding Guidelines

Inclusion Criteria

Use G83.5 When
  • According to ICD
  • 10 coding guidelines, G83
  • 5 should be used when the patient exhibits classic symptoms of locked
  • in state, with documentation supporting the diagnosis
  • It is important to include details about the onset, duration, and any associated conditions

Exclusion Criteria

Do NOT use G83.5 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

92507CPT Code

Treatment of speech, language, voice, and/or auditory processing disorder

Clinical Scenario

Used for patients with locked-in state requiring speech therapy.

Documentation Requirements

Document the patient's communication abilities and therapy goals.

Specialty Considerations

Speech therapists should note the methods used for communication.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of neurological conditions, including locked-in state, improving the accuracy of diagnoses and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of neurological conditions, including locked-in state, improving the accuracy of diagnoses and treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of neurological conditions, including locked-in state, improving the accuracy of diagnoses and treatment planning.

Resources

Clinical References

  • •
    Locked-in Syndrome: A Review

Coding & Billing References

  • •
    Locked-in Syndrome: A Review

Frequently Asked Questions

What is the primary cause of locked-in state?

Locked-in state is primarily caused by damage to the brainstem, often due to stroke, traumatic brain injury, or diseases like ALS.

How can patients with locked-in state communicate?

Patients can often communicate through eye movements or blinking, which should be documented in their care plan.