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

G81.9

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Hemiplegia, unspecified

Hemiplegia, unspecified

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
G81Hemiplegia and hemiparesis
G81.9Hemiplegia, unspecified

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for G81.9 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for G81.9 in this effective period.

Related Child Codes

Official
G81.90Hemiplegia, unspecified affecting unspecified side
G81.91Hemiplegia, unspecified affecting right dominant side
G81.92Hemiplegia, unspecified affecting left dominant side
G81.93Hemiplegia, unspecified affecting right nondominant side
G81.94Hemiplegia, unspecified affecting left nondominant side

Includes

Official

ICD-10-CM does not list Includes notes for G81.9 in this effective period.

Excludes 1

Official
  • congenital cerebral palsy (G80.-)
  • hemiplegia and hemiparesis due to sequela of cerebrovascular disease (I69.05-, I69.15-, I69.25-, I69.35-, I69.85-, I69.95-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for G81.9 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for G81.9 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for G81.9 in this effective period.

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.

What This Code Means

G81.9 is the ICD-10-CM diagnosis code for hemiplegia, unspecified. G81.9 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).

Header codes like G81.9 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at G81.9's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for G81.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

More on G81.9

Referenced in blog posts

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