G82.20
BillableParaplegia, unspecified
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is G82.20 an HCC code?
Yes. G82.20 maps to Paraplegia under the CMS-HCC V28 risk adjustment model (and Paraplegia 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 G82.20
For G82.20 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 G82.20 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
G82.20 is the ICD-10-CM diagnosis code for paraplegia, unspecified. Paralysis of both legs where the specific extent of the paralysis (complete or incomplete) is not documented or specified. G82.20 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, G82.20 maps to Paraplegia (HCC 181) with a community, non-dual, aged base RAF weight of 0.274. Under the older V24 model, G82.20 mapped to the same category but with a base RAF weight of 0.550 — 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.
Query the provider if documentation indicates whether the paraplegia is complete or incomplete, as more specific codes exist. Because G82.20 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 G82.20 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Query the provider if documentation indicates whether the paraplegia is complete or incomplete, as more specific codes exist
- •Use this code only when the completeness of the paralysis cannot be determined from the medical record
Clinical Significance
Unspecified paraplegia indicates loss of function in both lower extremities without documentation of whether the paralysis is complete or incomplete. This is a severe condition requiring wheelchair mobility, specialized equipment, skin integrity monitoring, and bladder/bowel management. Paraplegia drives very high healthcare resource utilization and significantly impacts the patient's risk profile for care needs prediction.
Documentation Requirements
- ✓Documentation of paraplegia (bilateral lower extremity paralysis)
- ✓Underlying cause (spinal cord injury, tumor, vascular, degenerative disease)
- ✓Level of spinal cord involvement when known
- ✓Functional status including mobility method (wheelchair, etc.)
- ✓Bladder and bowel function status
- ✓Skin integrity assessment and pressure injury prevention plan
- ✓Active management plan and equipment needs