G14
BillablePostpolio syndrome
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is G14 an HCC code?
Yes. G14 maps to Spinal Cord Disorders/Injuries under the CMS-HCC V28 risk adjustment model.
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for G14
For G14to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed G14 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
G14 is the ICD-10-CM diagnosis code for postpolio syndrome. A late-onset condition affecting people who previously had polio, characterized by progressive muscle weakness, pain, and fatigue that develops years or decades after the initial infection. G14 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering systemic atrophies primarily affecting the central nervous system (g10-g14).
Under the CMS-HCC V28 risk adjustment model, G14 maps to Spinal Cord Disorders/Injuries (HCC 182) with a community, non-dual, aged base RAF weight of 0.282. G14 was not retained as a payment HCC under the older V24 model, so V28 introduced or recategorized it during the 2024–2026 phase-in. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Document the history of polio infection in the medical record. Because G14 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G14 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the history of polio infection in the medical record
- •This code is used only for late manifestations, not for acute polio
Clinical Significance
Postpolio syndrome affects polio survivors years to decades after initial infection, causing new progressive muscle weakness, fatigue, and pain. With an estimated 300,000-400,000 postpolio survivors in the United States, this condition drives significant rehabilitation and pain management utilization and requires differentiation from other causes of weakness in aging patients.
Documentation Requirements
- ✓Documented history of prior poliomyelitis infection
- ✓New onset of progressive muscle weakness, fatigue, or pain years after initial infection
- ✓Typical latency period of 15-40 years between acute polio and new symptoms documented
- ✓Neurological examination confirming new weakness in previously affected or unaffected muscles
- ✓Exclusion of other causes of progressive weakness
- ✓Electromyography findings if performed showing chronic denervation with reinnervation
Includes
- postpolio myelitic syndrome
Excludes 1 — Do NOT code together
- sequelae of poliomyelitis (B91)
Commonly Confused Codes
- •B91 — Sequelae of poliomyelitis: for residual paralysis or deformity from acute polio, not new progressive symptoms
- •G12.29 — Other motor neuron disease: postpolio syndrome is not classified as a primary motor neuron disease
- •M79.3 — Panniculitis, unspecified: sometimes confused due to fatigue and pain overlap
- •G71.11 — Myotonic muscular dystrophy: progressive weakness in adults but different etiology