G82.54 ICD-10-CM Code: Quadriplegia, C5-C7 incomplete
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the nervous system (G00-G99) / Cerebral palsy and other paralytic syndromes (G80-G83)
G82.54
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceQuadriplegia, C5-C7 incomplete
Partial paralysis of all four limbs resulting from injury to the lower cervical spinal cord (C5-C7 vertebrae level), with some preservation of motor or sensory function below the injury.
Buddy Insight
Incomplete quadriplegia at the C5-C7 level represents the most favorable prognosis among quadriplegia diagnoses, with preserved function at a lower cervical level allowing for greater independence in self-care, mobility, and potentially even modified driving.
CMS-HCC V28
MappedHCC 180
RAF 0.274
CMS-HCC V24
MappedHCC 70
RAF 0.885
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 70
RAF 0.0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for G82.54 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for G82.54 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for G82.54 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for G82.54 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for G82.54 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for G82.54 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for G82.54 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 G82.54 an HCC code?
Yes. G82.54 maps to Quadriplegia under the CMS-HCC V28 risk adjustment model (and Quadriplegia 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 G82.54
For G82.54to 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 G82.54 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
G82.54 is the ICD-10-CM diagnosis code for quadriplegia, c5-c7 incomplete. Partial paralysis of all four limbs resulting from injury to the lower cervical spinal cord (C5-C7 vertebrae level), with some preservation of motor or sensory function below the injury. G82.54 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, G82.54 maps to Quadriplegia (HCC 180) with a community, non-dual, aged base RAF weight of 0.274. Under the older V24 model, G82.54 mapped to the same category but with a base RAF weight of 0.885, 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.
Incomplete quadriplegia at C5-C7 level generally has better functional prognosis than complete injuries at the same level. Because G82.54 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 G82.54 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Incomplete quadriplegia at C5-C7 level generally has better functional prognosis than complete injuries at the same level
- •Ensure documentation supports both the C5-C7 level and incomplete status before coding
Clinical Significance
Incomplete quadriplegia at the C5-C7 level represents the most favorable prognosis among quadriplegia diagnoses, with preserved function at a lower cervical level allowing for greater independence in self-care, mobility, and potentially even modified driving. Rehabilitation potential is highest in this category, and patients may achieve significant functional gains with intensive therapy. Distinguishing this from other quadriplegia levels is essential for appropriate goal-setting.
Documentation Requirements
- ✓Documentation specifying C5-C7 level with incomplete quadriplegia
- ✓Description of preserved motor and sensory function
- ✓Neurological assessment details (ASIA classification if available)
- ✓Underlying etiology
- ✓Functional assessment and independence level
- ✓Rehabilitation progress and goals
- ✓Active treatment plan
- ✓Equipment and assistive device needs
Commonly Confused Codes
- •G82.53 Quadriplegia, C5-C7 complete: no preserved function at this level
- •G82.52 Quadriplegia, C1-C4 incomplete: higher level with typically more severe deficits
- •G82.50 Quadriplegia, unspecified: use when neither level nor completeness is documented
- •G82.22 Paraplegia, incomplete: only lower extremities affected