V28 HCC 181
Paraplegia
Under the CMS-HCC V28 risk adjustment model (PY2026 Medicare Advantage), HCC 181 has a source-labeled community non-dual aged reference coefficient of 0.942, and 18 ICD-10-CM diagnosis codes appear in its official mapping. In the V28 hierarchy it is superseded by HCC 180, HCC 191, HCC 192 when a more severe category in the same disease group is also present.
RAF factors
The community factor varies by Medicaid and originally-disabled status; the institutional factor applies to long-term-institutional members. These are the CMS-HCC V28 PY2026 relative factors.
These are source-labeled code-level HCC coefficient references, not a full member score. Use the RAF Calculator with complete member context for CMS-HCC V28 PY2026. No score is shown unless every required source and calculation check passes.
V28 hierarchy
Trumped by: HCC 180, HCC 191, HCC 192 (a more severe category in the same disease group supersedes this one).
Supersedes: HCC 182, HCC 254 (this category is counted instead of these when they co-occur).
ICD-10-CM codes that map to HCC 181 (18)
ICD-10-CM codes in the official mapping for this category under CMS-HCC V28 PY2026. Open any code for its full description and coding guidance.
- G82.20Paraplegia, unspecified
- G82.21Paraplegia, complete
- G82.22Paraplegia, incomplete
- S24.111AComplete lesion at T1 level of thoracic spinal cord, initial encounter
- S24.111DComplete lesion at T1 level of thoracic spinal cord, subsequent encounter
- S24.111SComplete lesion at T1 level of thoracic spinal cord, sequela
- S24.112AComplete lesion at T2-T6 level of thoracic spinal cord, initial encounter
- S24.112DComplete lesion at T2-T6 level of thoracic spinal cord, subsequent encounter
- S24.112SComplete lesion at T2-T6 level of thoracic spinal cord, sequela
- S24.113AComplete lesion at T7-T10 level of thoracic spinal cord, initial encounter
- S24.113DComplete lesion at T7-T10 level of thoracic spinal cord, subsequent encounter
- S24.113SComplete lesion at T7-T10 level of thoracic spinal cord, sequela
- S24.114AComplete lesion at T11-T12 level of thoracic spinal cord, initial encounter
- S24.114DComplete lesion at T11-T12 level of thoracic spinal cord, subsequent encounter
- S24.114SComplete lesion at T11-T12 level of thoracic spinal cord, sequela
- S24.119AComplete lesion at unspecified level of thoracic spinal cord, initial encounter
- S24.119DComplete lesion at unspecified level of thoracic spinal cord, subsequent encounter
- S24.119SComplete lesion at unspecified level of thoracic spinal cord, sequela
Coder workflow notes
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Frequently asked questions
What is CMS-HCC V28 category 181?
HCC 181 is "Paraplegia", a Hierarchical Condition Category in the CMS-HCC V28 risk adjustment model (100% phase-in for payment year 2026). 18 ICD-10-CM codes appear in its official mapping.
What reference coefficient is published for HCC 181?
The source-labeled community non-dual aged reference coefficient for CMS-HCC V28 category 181 is 0.942. The exact coefficient varies by enrollment segment (community Medicaid and originally-disabled status, and institutional); the full segment table is published in the CMS V28 model files.
How many ICD-10-CM codes map to HCC 181?
18 ICD-10-CM diagnosis codes appear in the official mapping for CMS-HCC V28 category 181 (Paraplegia) for payment year 2026.
Which categories trump HCC 181 in the V28 hierarchy?
HCC 181 is superseded by HCC 180 (Quadriplegia), HCC 191 (Quadriplegic Cerebral Palsy), HCC 192 (Cerebral Palsy, Except Quadriplegic). When a more severe category in the same disease group is documented, it is counted instead of HCC 181.
Related references
Sources
CMS ICD-10-CM order-file billability plus the published mapping and CMS-HCC V28 PY2026 model software. CMS-HCC V28 model published at CMS.gov Risk Adjustors; ICD-10-CM member codes from the CMS ICD-10-CM code set.
Verified current to CMS-HCC V28, payment year 2026 — last reviewed May 30, 2026.