G83.5
BillableLocked-in state
HCC Category Mapping
V28HCC 254 — Monoplegia, Other Paralytic Syndromes
0.000V24HCC 104 — Monoplegia, Other Paralytic Syndromes
0.304ESRDHCC 104 — Monoplegia, Other Paralytic Syndromes
0.000What This Code Means
A rare neurological condition where a person is completely paralyzed but remains conscious and aware, unable to move or speak but able to think and perceive.
Coding Tips
- •This code requires careful documentation to distinguish from coma or vegetative states
- •Document the underlying cause (stroke, trauma, disease) separately for complete clinical picture
Clinical Significance
Locked-in state is a devastating neurological condition typically caused by basilar artery occlusion or pontine hemorrhage, where the patient is fully conscious and aware but completely paralyzed except for vertical eye movements and blinking. These patients require total care including ventilator support, nutritional management, and comprehensive medical oversight. This is one of the most resource-intensive conditions in neurology, and proper coding is essential for care planning.
Documentation Requirements
- ✓Explicit documentation of locked-in state/syndrome
- ✓Distinction from coma, persistent vegetative state, or brain death
- ✓Documentation of preserved consciousness and awareness (eye tracking, communication via blinks)
- ✓Underlying etiology (basilar artery stroke, pontine hemorrhage, demyelination, etc.)
- ✓Ventilator and nutritional support status
- ✓Communication method (eye blinks, specialized devices)
- ✓Total care dependency documentation
- ✓Active comprehensive management plan
Commonly Confused Codes
R40.20 Unspecified coma — patient is unconscious; locked-in patient is consciousG82.50 Quadriplegia, unspecified — quadriplegia without the specific pontine syndromeG93.1 Anoxic brain damage — diffuse brain injury, different mechanismR40.4 Transient alteration of awareness — temporary condition, unlike locked-in stateG83.89 Other specified paralytic syndromes — less specific paralysis code