G25.81 ICD-10-CM Code: Restless legs syndrome
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Extrapyramidal and movement disorders (G20-G26)
G25.81
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceRestless legs syndrome
Restless legs syndrome is a condition where a person experiences uncomfortable sensations in their legs, usually in the evening or at night, that create an irresistible urge to move them. This discomfort often interferes with sleep and can significantly impact quality of life.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for G25.81 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for G25.81 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for G25.81 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for G25.81 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for G25.81 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for G25.81 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for G25.81 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is G25.81 an HCC code?
No. G25.81 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- G25.81
- Description
- Restless legs syndrome
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
G25.81 is the ICD-10-CM diagnosis code for restless legs syndrome. Restless legs syndrome is a condition where a person experiences uncomfortable sensations in their legs, usually in the evening or at night, that create an irresistible urge to move them. This discomfort often interferes with sleep and can significantly impact quality of life. G25.81 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering extrapyramidal and movement disorders (g20-g26).
G25.81 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Verify that the diagnosis is specifically documented as restless legs syndrome (RLS) or Willis-Ekbom disease in the medical record before coding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G25.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify that the diagnosis is specifically documented as restless legs syndrome (RLS) or Willis-Ekbom disease in the medical record before coding
- •This code is typically used for chronic management; ensure documentation supports the ongoing nature of the condition and consider linking to sleep-related diagnoses if applicable