What is ICD-10 code G81.01?

G81.01 is the ICD-10-CM diagnosis code for Flaccid hemiplegia affecting right dominant side. Weakness or paralysis affecting the right side of the body with floppy, loose muscle tone in a right-handed person. It belongs to the ICD-10-CM chapter for diseases of the nervous system (g00-g99). G81.01 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. G81.01 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. G81.01 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. G81.01 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for G81.01?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For G81.01, V28 maps to Hemiplegia/Hemiparesis at RAF 0.000 while V24 mapped to Hemiplegia/Hemiparesis at RAF 0.447. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting G81.01?

Ensure documentation specifies both the side affected (right) and dominance (dominant) for accurate coding Common after stroke; review acute care records for onset and etiology Because G81.01 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

G81.01 ICD-10 Code: Flaccid hemiplegia affecting

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupG81.01Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Cerebral palsy and other paralytic syndromes (G80-G83)

G81.01

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Flaccid hemiplegia affecting right dominant side

Weakness or paralysis affecting the right side of the body with floppy, loose muscle tone in a right-handed person.

Buddy Insight

CMS-HCC V28

Mapped

HCC 253

Hemiplegia/Hemiparesis

RAF 0.0

CMS-HCC V24

Mapped

HCC 103

Hemiplegia/Hemiparesis

RAF 0.447

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 103

Hemiplegia/Hemiparesis

RAF 0.0

RXHCC

Not risk-adjusted for this model/period.

RAF 0

Code Trumping

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Code Book Path

Official

G81Hemiplegia and hemiparesis

G81.0Flaccid hemiplegia

G81.01Flaccid hemiplegia affecting right dominant side

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for G81.01 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for G81.01 in this effective period.

Related Child Codes

Official

G81.00Flaccid hemiplegia affecting unspecified side

G81.02Flaccid hemiplegia affecting left dominant side

G81.03Flaccid hemiplegia affecting right nondominant side

G81.04Flaccid hemiplegia affecting left nondominant side

Includes

Official

ICD-10-CM does not list Includes notes for G81.01 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for G81.01 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for G81.01 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for G81.01 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for G81.01 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documentation of hemiplegia specifically described as flaccid (low muscle tone)

Right side specified as the affected side

Dominance documented (right-handed or right-dominant)

Underlying cause documented and coded separately

MEAT Support

HCC Buddy guidance

Documentation of hemiplegia specifically described as flaccid (low muscle tone)

Right side specified as the affected side

Dominance documented (right-handed or right-dominant)

Underlying cause documented and coded separately

Audit Caution

HCC Buddy guidance

Assuming right-sided involvement always means dominant — must verify handedness/dominance in the record

Using this code when the hemiplegia resulted from a stroke without using the appropriate I69 sequelae code instead

Failing to distinguish between flaccid and spastic presentations which require different codes

Not reporting this condition annually even though it is chronic and stable

Common Mistakes

HCC Buddy guidance

G81.03 Flaccid hemiplegia affecting right nondominant side — right side affected but in a left-handed person

G81.11 Spastic hemiplegia affecting right dominant side — same laterality/dominance but spastic rather than flaccid tone

G81.91 Hemiplegia, unspecified affecting right dominant side — use when tone type is not documented

I69.051 Hemiplegia following cerebrovascular disease, right dominant — use when directly attributable to stroke sequelae

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is G81.01 an HCC code?

Yes. G81.01 maps to Hemiplegia/Hemiparesis under the CMS-HCC V28 risk adjustment model (and Hemiplegia/Hemiparesis under V24).

HCC Category Mapping

V28HCC 253, Hemiplegia/Hemiparesis

0.000

V24HCC 103, Hemiplegia/Hemiparesis

0.447

ESRDHCC 103, Hemiplegia/Hemiparesis

0.000

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 G81.01

For G81.01to 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 G81.01 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

G81.01 is the ICD-10-CM diagnosis code for flaccid hemiplegia affecting right dominant side. Weakness or paralysis affecting the right side of the body with floppy, loose muscle tone in a right-handed person. G81.01 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, G81.01 maps to Hemiplegia/Hemiparesis (HCC 253) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, G81.01 mapped to the same category but with a base RAF weight of 0.447, V28 recalibrated weights across the entire model. 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.

Ensure documentation specifies both the side affected (right) and dominance (dominant) for accurate coding. Because G81.01 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 G81.01 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Ensure documentation specifies both the side affected (right) and dominance (dominant) for accurate coding
•Common after stroke; review acute care records for onset and etiology

Clinical Significance

Flaccid hemiplegia affecting the right dominant side represents one of the most functionally debilitating presentations, as the patient loses tone and function in their primary hand and dominant extremities. This dramatically impacts writing, feeding, dressing, and most daily activities. The specificity of this code — identifying both the flaccid type and dominant side involvement — reflects documentation quality that supports accurate risk adjustment.

Documentation Requirements

✓Documentation of hemiplegia specifically described as flaccid (low muscle tone)
✓Right side specified as the affected side
✓Dominance documented (right-handed or right-dominant)
✓Underlying cause documented and coded separately
✓Neurological examination findings supporting flaccid presentation
✓Functional status and impact on activities of daily living
✓Active treatment plan including rehabilitation services

Commonly Confused Codes

•G81.03 Flaccid hemiplegia affecting right nondominant side: right side affected but in a left-handed person
•G81.11 Spastic hemiplegia affecting right dominant side: same laterality/dominance but spastic rather than flaccid tone
•G81.91 Hemiplegia, unspecified affecting right dominant side: use when tone type is not documented
•I69.051 Hemiplegia following cerebrovascular disease, right dominant: use when directly attributable to stroke sequelae