G82.21

HCC Category Mapping

What This Code Means

Complete paraplegia is a condition where a person has total loss of function and sensation in both legs due to spinal cord damage or injury. This means the person cannot move or feel their legs and typically requires a wheelchair for mobility.

Coding Tips

• •Verify the documentation specifies 'complete' paraplegia versus 'incomplete' (G82.20) as this distinction is clinically and functionally significant
• •Ensure the underlying cause of paraplegia is documented and coded separately (such as spinal cord injury, trauma, or disease) to provide complete clinical picture

Clinical Significance

Complete paraplegia represents total loss of motor and sensory function in both lower extremities, indicating the most severe form of lower body paralysis. These patients are fully wheelchair-dependent and at high risk for pressure injuries, urinary tract infections, deep vein thrombosis, and autonomic dysreflexia. The resource demands are among the highest in risk adjustment models, and accurate capture is critical for appropriate plan payment.

Documentation Requirements

• ✓Documentation explicitly stating paraplegia is 'complete'
• ✓Verification of total loss of motor AND sensory function below the injury level
• ✓Spinal cord level of injury
• ✓Underlying etiology (traumatic injury, tumor, vascular event, etc.)
• ✓Bladder and bowel management approach
• ✓Skin integrity monitoring and pressure injury prevention
• ✓Wheelchair and adaptive equipment needs
• ✓Active management plan and specialist involvement

Commonly Confused Codes