G80.1 ICD-10-CM Code: Spastic diplegic cerebral palsy
G80.1 maps to CMS-HCC V28 192. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · HCC Buddy coding tools
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Cerebral palsy and other paralytic syndromes (G80-G83)
G80.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceSpastic diplegic cerebral palsy
A type of cerebral palsy primarily affecting both legs with stiff, rigid muscle tone, while arms are less affected or unaffected.
Buddy Insight
Spastic diplegic cerebral palsy is the most common type of cerebral palsy, primarily affecting the lower extremities with spasticity while relatively sparing the upper body.
CMS-HCC V28
MappedHCC 192
Code-level coefficient reference
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 113
Code-level coefficient reference
ESRD/PACE
MappedHCC 74
Code-level coefficient reference
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Spastic cerebral palsy NOS
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for G80.1 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for G80.1 in this effective period.
Excludes 1
Official- hereditary spastic paraplegia (G11.4)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for G80.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for G80.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for G80.1 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 G80.1 an HCC code?
Yes. G80.1 (Spastic diplegic cerebral palsy) maps to HCC 192, Cerebral Palsy, Except Quadriplegic under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.314. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: G80.1 is billable and maps to V28 HCC 192, Cerebral Palsy, Except Quadriplegic. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- G80.1
- Description
- Spastic diplegic cerebral palsy
- HCC (V28)
- HCC 192 — Cerebral Palsy, Except Quadriplegic
- RAF reference coefficient
- 0.314
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work G80.1 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT Criteria for G80.1
For G80.1 to 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 G80.1 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
Get the V28 mapping + MEAT cheat sheet
One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.
Free PDF. No card. Unsubscribe anytime.
What This Code Means
G80.1 is the ICD-10-CM diagnosis code for spastic diplegic cerebral palsy. A type of cerebral palsy primarily affecting both legs with stiff, rigid muscle tone, while arms are less affected or unaffected. G80.1 sits in the ICD-10-CM chapter for diseases of the nervous system (g00-g99), within the section covering cerebral palsy and other paralytic syndromes (g80-g83).
Under the CMS-HCC V28 risk adjustment model, G80.1 maps to Cerebral Palsy, Except Quadriplegic (HCC 192) with a source-labeled community, non-dual, aged reference coefficient of 0.314. No V24 mapping is shown for G80.1; use the applicable model and payment year when reviewing the V28 mapping. 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. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Spastic diplegia is the most common form of cerebral palsy; document functional limitations and mobility status. Because G80.1 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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, source-labeled coefficient references, and MEAT documentation criteria for G80.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Spastic diplegia is the most common form of cerebral palsy; document functional limitations and mobility status
- •Often associated with prematurity; review birth history documentation for coding accuracy
Clinical Significance
Spastic diplegic cerebral palsy is the most common type of cerebral palsy, primarily affecting the lower extremities with spasticity while relatively sparing the upper body. It is strongly associated with premature birth and periventricular leukomalacia. These patients require ongoing physical therapy, orthopedic management, and mobility support. Accurate coding captures the chronic rehabilitative care needs.
Documentation Requirements
- ✓Diagnosis of cerebral palsy with spastic diplegic type specified
- ✓Predominant involvement of lower extremities documented
- ✓Birth history: prematurity, periventricular leukomalacia when applicable
- ✓Ambulatory status: independent, assisted, wheelchair-dependent
- ✓Associated conditions: learning disabilities, strabismus, urinary issues
- ✓Current interventions: physical therapy, orthopedic procedures, assistive devices
Commonly Confused Codes
- •G80.0: Spastic quadriplegic cerebral palsy involves all four limbs severely; diplegia primarily affects legs
- •G80.2: Spastic hemiplegic cerebral palsy affects one side only, not bilateral lower extremities
- •G82.20: Paraplegia, unspecified is for acquired spinal cord-level paralysis, not cerebral palsy
- •G80.9: Cerebral palsy, unspecified should not be used when the diplegic pattern is documented