G83.11
BillableMonoplegia of lower limb affecting right dominant side
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is G83.11 an HCC code?
Yes. G83.11 maps to Monoplegia, Other Paralytic Syndromes under the CMS-HCC V28 risk adjustment model (and Monoplegia, Other Paralytic Syndromes 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 G83.11
For G83.11 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 G83.11 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
G83.11 is the ICD-10-CM diagnosis code for monoplegia of lower limb affecting right dominant side. Weakness or paralysis affecting only the right leg in a person whose right side is their dominant side. G83.11 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, G83.11 maps to Monoplegia, Other Paralytic Syndromes (HCC 254) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, G83.11 mapped to the same category but with a base RAF weight of 0.304 — 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 dominance documentation in the medical record; if not specified, query the provider before assigning dominant/nondominant codes. Because G83.11 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 G83.11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify dominance documentation in the medical record; if not specified, query the provider before assigning dominant/nondominant codes
- •Ensure the monoplegia is isolated to the lower limb; if both upper and lower limbs are affected, use a different code
Clinical Significance
Monoplegia of the lower limb affecting the right dominant side indicates paralysis of the right leg in a right-dominant individual. This affects the patient's ability to perform weight-bearing activities on their stronger side, impacting gait stability and transfer ability. The concept of lower limb dominance is less commonly documented than upper limb dominance, which may require specific provider query.
Documentation Requirements
- ✓Documentation of monoplegia isolated to the right lower extremity
- ✓Right-side dominance confirmed
- ✓Underlying etiology documented
- ✓Neurological examination findings confirming paralysis
- ✓Mobility and functional status assessment
- ✓Assistive device requirements
- ✓Active rehabilitation or management plan
Commonly Confused Codes
- •G83.13 Monoplegia of lower limb, right nondominant — right leg in a left-dominant person
- •G83.10 Monoplegia of lower limb, unspecified side — use when laterality is unknown
- •G81.01 Flaccid hemiplegia, right dominant — involves both upper and lower right extremities
- •M79.604 Pain in right leg — pain is not the same as paralysis