G04.1
BillableTropical spastic paraplegia
HCC Category Mapping
V28HCC 182 — Spinal Cord Disorders/Injuries
0.282V24HCC 72 — Spinal Cord Disorders/Injuries
0.464ESRDHCC 72 — Spinal Cord Disorders/Injuries
0.000RxHCCHCC 155 — Myelitis and Encephalomyelitis
0.000What This Code Means
A progressive neurological disorder causing weakness and spasticity in the legs, primarily found in tropical regions and associated with HTLV-1 infection.
Coding Tips
- •Confirm HTLV-1 serology or other diagnostic evidence of tropical spastic paraplegia
- •Code the underlying HTLV-1 infection separately if documented
Clinical Significance
Tropical spastic paraplegia is a progressive myelopathy associated with HTLV-1 infection that causes significant disability through lower extremity weakness and spasticity. This diagnosis signals a chronic neurological condition requiring ongoing specialist management, rehabilitation services, and monitoring for HTLV-1 associated complications including potential malignancy.
Documentation Requirements
- ✓HTLV-1 serology results or documented positive status
- ✓Progressive lower extremity weakness and spasticity documented on exam
- ✓Neurological examination findings (hyperreflexia, Babinski sign, spastic gait)
- ✓MRI or other imaging of spinal cord if available
- ✓Duration and progression of symptoms
- ✓Current functional status and mobility limitations
Commonly Confused Codes
G04.89 — Other myelitis: used when the cause is known but not HTLV-1 related tropical spastic paraplegiaG35 — Multiple sclerosis: can present similarly with spastic paraplegia but has different etiology and imaging findingsG04.91 — Myelitis, unspecified: should not be used when HTLV-1 associated myelopathy is documentedG82.20 — Paraplegia, unspecified: describes the symptom, not the specific disease process
Code Hierarchy
└G04Encephalitis, myelitis and encephalomyelitis└G04.1Tropical spastic paraplegia
└G04.1Tropical spastic paraplegia