2025 ICD-10-CM code G81
(Valid) Effective Date: N/A Cerebral palsy and other paralytic syndromes - G80-G83 6 Feed
Hemiplegia and hemiparesis. This category is used when hemiplegia (complete or incomplete) is reported without further specification, is old or longstanding, or has an unspecified cause. It is also used in multiple coding to identify these conditions resulting from any cause.
Medical necessity is established by the underlying cause of the hemiplegia or hemiparesis.Documentation should support the diagnosis and the need for treatment and/or management of the condition.
Clinicians diagnose hemiplegia/hemiparesis based on medical history, physical examination, and neurological assessment. Diagnostic tests such as CT, MRI, EEG, blood tests, and cerebrospinal fluid analysis may be conducted to determine the underlying cause and guide treatment. Treatment focuses on addressing the root cause and managing symptoms, and may involve medications, physical therapy, occupational therapy, speech therapy, and assistive devices.
In simple words: Hemiplegia means you can't move one side of your body at all, while hemiparesis means that same side is weak. This can happen because of problems in the brain or spinal cord, like a stroke, infection, or injury.Sometimes it happens because of conditions like cerebral palsy or multiple sclerosis.
Hemiplegia and hemiparesis refer to a spectrum of conditions characterized by weakness or paralysis on one side of the body. Hemiplegia denotes severe or complete loss of strength, while hemiparesis signifies mild to moderate weakness. These conditions can affect the arm, leg, and sometimes the face, all on the same side. The underlying cause is typically damage to the brain or spinal cord, disrupting communication between the nervous system and muscles. Various factors can lead to hemiplegia or hemiparesis, including stroke, brain infections, traumatic injuries, cerebral palsy, brain tumors, multiple sclerosis, and other neurological disorders.
Example 1: A patient presents with sudden onset of right-sided weakness and facial drooping following a stroke. The patient is diagnosed with G81 (hemiplegia and hemiparesis) due to the cerebrovascular accident. , A child exhibits left-sided weakness and spasticity since birth due to cerebral palsy. While G80 codes are generally used for cerebral palsy, if the documentation specifies hemiplegia or hemiparesis without further details, G81 can be used., An individual experiences progressive weakness on one side of the body due to a growing brain tumor. Imaging confirms the diagnosis, and the hemiplegia/hemiparesis is coded as G81.
Documentation should clearly specify "hemiplegia" or "hemiparesis," laterality (right or left), and any associated symptoms.The underlying cause (e.g., stroke, trauma) must also be documented.If the condition is longstanding or of unspecified cause, this should be explicitly stated.
** Excludes1: congenital cerebral palsy (G80.-) hemiplegia and hemiparesis due to sequela of cerebrovascular disease (I69.05-, I69.15-, I69.25-, I69.35-, I69.85-, I69.95-)Excludes2: certain conditions originating in the perinatal period (P04-P96)certain infectious and parasitic diseases (A00-B99)complications of pregnancy, childbirth and the puerperium (O00-O9A)congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)endocrine, nutritional and metabolic diseases (E00-E88)injury, poisoning and certain other consequences of external causes (S00-T88)neoplasms (C00-D49)symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- Specialties:Neurology, Physical Medicine and Rehabilitation, Pediatrics (if applicable)
- Place of Service:Inpatient Hospital, Outpatient Hospital, Skilled Nursing Facility, Rehabilitation Facility, Physician's Office