G81.14
BillableSpastic hemiplegia affecting left nondominant side
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is G81.14 an HCC code?
Yes. G81.14 maps to Hemiplegia/Hemiparesis under the CMS-HCC V28 risk adjustment model (and Hemiplegia/Hemiparesis under V24).
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 G81.14
For G81.14to 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 G81.14 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
G81.14 is the ICD-10-CM diagnosis code for spastic hemiplegia affecting left nondominant side. This condition involves weakness and stiffness (spasticity) affecting the left side of the body due to damage to the brain or spinal cord. The left side is the person's non-dominant side, meaning their right side is their stronger, more coordinated side. G81.14 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, G81.14 maps to Hemiplegia/Hemiparesis (HCC 253) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, G81.14 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.
Verify documentation specifies the affected side (left) and confirm it is the non-dominant side; if dominance is not documented, query the provider before coding. Because G81.14 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 G81.14 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies the affected side (left) and confirm it is the non-dominant side; if dominance is not documented, query the provider before coding
- •This code requires a 5th character to indicate laterality; ensure the complete code G81.14 is used and not confused with G81.11 (right nondominant) or G81.12/G81.13 (dominant side codes)
Clinical Significance
Spastic hemiplegia affecting the left nondominant side is the most common presentation of spastic hemiplegia since most people are right-handed. Left-sided spasticity from right-hemisphere brain lesions typically causes spatial neglect and balance issues in addition to motor deficits. Ongoing spasticity management is critical to prevent complications like contractures, pain, and functional decline.
Documentation Requirements
- ✓Documentation of spastic (increased tone) hemiplegia
- ✓Left side specified as affected
- ✓Right-hand dominance documented (left is nondominant)
- ✓Underlying cause documented and coded
- ✓Spasticity severity assessment
- ✓Functional status including mobility and self-care ability
- ✓Treatment plan addressing spasticity management
Commonly Confused Codes
- •G81.12 Spastic hemiplegia affecting left dominant side — left side in a left-handed person
- •G81.04 Flaccid hemiplegia affecting left nondominant side — same laterality but flaccid tone
- •G81.94 Hemiplegia, unspecified affecting left nondominant side — when tone type is undocumented
- •I69.054 Hemiplegia following cerebrovascular disease, left nondominant — for stroke sequelae