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G81.10 ICD-10-CM Code: Spastic hemiplegia affecting unspecified side

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
2 Excludes1
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 103 · RxHCC V08 category 207

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 056 — DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC (MDC 01)
  • MS-DRG 057 — DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC (MDC 01)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 253 — Hemiplegia/Hemiparesis (supersedes HCC 254)

Other models: CMS-HCC V22 HCC 103 · RxHCC V08 HCC 207

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for G81.10 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on G81.10 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from G81

Coder workflow for G81.10

MedCoder structured workflow — derived from this code’s own official record

Before you code G81.10

  1. Unspecified does not mean incorrect. When the record gives no greater specificity, G81.10 may be the appropriate code. Check the record for detail that supports a more specific sibling. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).

    ReviewG81.11, G81.12, G81.13, G81.14

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

  2. Laterality is coded in this family. Confirm the side documented — right, left, or bilateral — and select the matching code (this page’s code: unspecified). The unspecified-side code applies only when the record states no side. Laterality is assigned from the documented side; where a bilateral code exists and both sides are documented, it is used instead of two unilateral codes (Guidelines I.B.13).

    See the relationships section · Guide: Laterality coding →

  3. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with G81.10. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the record document the detail a more specific sibling code needs?
    Yes → Review the specific siblings in this subcategory.
    No → Continue — G81.10 is appropriate when the documentation goes no further.

    ReviewG81.11, G81.12, G81.13, G81.14

  2. Does the documentation support a condition named in G81.10’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewG80, I69.05, I69.15, I69.25, I69.35, I69.85

  3. Is the side documented?
    Yes → Select the code for the documented side (or the bilateral code when both sides are documented and one exists).
    No → Use the unspecified-side code only when the record states no side; a query is the alternative.

Consider G81.10. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Laterality
Right, left or bilateral as documented; unspecified only when the record states no side (Guidelines I.B.13).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

  • Excludes1 — check before selecting G81.10(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with G81.10: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareG80, I69.05, I69.15, I69.25, I69.35, I69.85

    See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The provider documents the condition in the terms of this code’s title and records no further detail.

Coding question: Is a more specific sibling code supportable?

Path: Review the specific siblings in this subcategory and what each requires the record to state.

Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).

ReviewG81.11, G81.12, G81.13, G81.14

Documentation: Both the condition G81.10 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewG80, I69.05, I69.15, I69.25, I69.35, I69.85

Documentation: The record documents the condition on one side only.

Coding question: Which code in this family applies?

Path: Select the sibling code for the documented side.

Reason: Laterality is assigned from the documented side; the unspecified-side code is for records that state no side (Guidelines I.B.13).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse G81.10 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of G81.10 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • G80— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of congenital cerebral palsy moves the case to G80; the two are not reported together unless documented as unrelated.

    Full comparison: G81.10 vs G80 →

  • I69.05— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of hemiplegia and hemiparesis due to sequela of cerebrovascular disease moves the case to I69.05; the two are not reported together unless documented as unrelated.

    Full comparison: G81.10 vs I69.05 →

  • I69.15— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of hemiplegia and hemiparesis due to sequela of cerebrovascular disease moves the case to I69.15; the two are not reported together unless documented as unrelated.

    Full comparison: G81.10 vs I69.15 →

  • I69.25— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of hemiplegia and hemiparesis due to sequela of cerebrovascular disease moves the case to I69.25; the two are not reported together unless documented as unrelated.

    Full comparison: G81.10 vs I69.25 →

  • I69.35— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of hemiplegia and hemiparesis due to sequela of cerebrovascular disease moves the case to I69.35; the two are not reported together unless documented as unrelated.

    Full comparison: G81.10 vs I69.35 →

  • I69.85— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of hemiplegia and hemiparesis due to sequela of cerebrovascular disease moves the case to I69.85; the two are not reported together unless documented as unrelated.

    Full comparison: G81.10 vs I69.85 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Code Overview

Spastic hemiplegia affecting unspecified side is a billable ICD-10-CM diagnosis code (G81.10).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 6: Diseases of the Nervous System (G00-G99)

a. Dominant/nondominant side Codes from category G81, Hemiplegia and hemiparesis, and subcategories G83.1, Monoplegia of lower limb, G83.2, Monoplegia of upper limb, and G83.3, Monoplegia, unspecified, identify whether the dominant or nondominant side is affected. Should the affected side be documented, but not specified as dominant or nondominant, and the classification system does not indicate a default, code selection is as follows: • For ambidextrous patients, the default should be dominant. • If the left side is affected, the default is non-dominant. • If the right side is affected, the default is dominant.

Verify Before Coding

  • CC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 138 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 2 MS-DRGs: DRG 056 (MDC 01), DRG 057 (MDC 01).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):NVS008 — Paralysis (other than cerebral palsy) (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

G80.1 — Spastic diplegic cerebral palsy, G80.2 — Spastic hemiplegic cerebral palsy, G80.4 — Ataxic cerebral palsy, G80.8 — Other cerebral palsy, G80.9 — Cerebral palsy, unspecified, G81.00 — Flaccid hemiplegia affecting unspecified side, G81.01 — Flaccid hemiplegia affecting right dominant side, G81.02 — Flaccid hemiplegia affecting left dominant side, G81.03 — Flaccid hemiplegia affecting right nondominant side, G81.04 — Flaccid hemiplegia affecting left nondominant side, G81.11 — Spastic hemiplegia affecting right dominant side, G81.12 — Spastic hemiplegia affecting left dominant side, G81.13 — Spastic hemiplegia affecting right nondominant side, G81.14 — Spastic hemiplegia affecting left nondominant side, G81.90 — Hemiplegia, unspecified affecting unspecified side, G81.91 — Hemiplegia, unspecified affecting right dominant side, G81.92 — Hemiplegia, unspecified affecting left dominant side, G81.93 — Hemiplegia, unspecified affecting right nondominant side, G81.94 — Hemiplegia, unspecified affecting left nondominant side, G82.20 — Paraplegia, unspecified, +117 more

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Hemiplegia/Hemiparesis) for risk-adjusted payment.

G81.00 — Flaccid hemiplegia affecting unspecified side, G81.01 — Flaccid hemiplegia affecting right dominant side, G81.02 — Flaccid hemiplegia affecting left dominant side, G81.03 — Flaccid hemiplegia affecting right nondominant side, G81.04 — Flaccid hemiplegia affecting left nondominant side, G81.11 — Spastic hemiplegia affecting right dominant side, G81.12 — Spastic hemiplegia affecting left dominant side, G81.13 — Spastic hemiplegia affecting right nondominant side, G81.14 — Spastic hemiplegia affecting left nondominant side, G81.90 — Hemiplegia, unspecified affecting unspecified side, G81.91 — Hemiplegia, unspecified affecting right dominant side, G81.92 — Hemiplegia, unspecified affecting left dominant side, G81.93 — Hemiplegia, unspecified affecting right nondominant side, G81.94 — Hemiplegia, unspecified affecting left nondominant side, I69.051 — Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right dominant side, I69.052 — Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left dominant side, I69.053 — Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right non-dominant side, I69.054 — Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left non-dominant side, I69.059 — Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting unspecified side, I69.151 — Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right dominant side, +24 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Quadriplegia, Monoplegia, Other Paralytic Syndromes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Paralysis (other than cerebral palsy)).

G04.1 — Tropical spastic paraplegia, G81.00 — Flaccid hemiplegia affecting unspecified side, G81.01 — Flaccid hemiplegia affecting right dominant side, G81.02 — Flaccid hemiplegia affecting left dominant side, G81.03 — Flaccid hemiplegia affecting right nondominant side, G81.04 — Flaccid hemiplegia affecting left nondominant side, G81.11 — Spastic hemiplegia affecting right dominant side, G81.12 — Spastic hemiplegia affecting left dominant side, G81.13 — Spastic hemiplegia affecting right nondominant side, G81.14 — Spastic hemiplegia affecting left nondominant side, G81.90 — Hemiplegia, unspecified affecting unspecified side, G81.91 — Hemiplegia, unspecified affecting right dominant side, G81.92 — Hemiplegia, unspecified affecting left dominant side, G81.93 — Hemiplegia, unspecified affecting right nondominant side, G81.94 — Hemiplegia, unspecified affecting left nondominant side, G82.20 — Paraplegia, unspecified, G82.21 — Paraplegia, complete, G82.22 — Paraplegia, incomplete, G82.50 — Quadriplegia, unspecified, G82.51 — Quadriplegia, C1-C4 complete, +27 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Hemiplegia”; these codes share that main term but sit in a different category of the Tabular List.

F44.4 — Conversion disorder with motor symptom or deficit (hysterical), G80.2 — Spastic hemiplegic cerebral palsy (congenital, spastic), G80.8 — Other cerebral palsy (congenital), G83.89 — Other specified paralytic syndromes (alternans facialis), G95.89 — Other specified diseases of spinal cord (ascending NEC, spinal), I63.3 — Cerebral infarction due to thrombosis of cerebral arteries (thrombotic), I63.4 — Cerebral infarction due to embolism of cerebral arteries (embolic), I69.05 — Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage (following, cerebrovascular disease, subarachnoid hemorrhage), I69.15 — Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage (following, cerebrovascular disease, intracerebral hemorrhage), I69.25 — Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage (following, cerebrovascular disease, nontraumatic intracranial hemorrhage NEC), I69.35 — Hemiplegia and hemiparesis following cerebral infarction (following, cerebrovascular disease, stroke NOS), I69.85 — Hemiplegia and hemiparesis following other cerebrovascular disease (following, cerebrovascular disease, specified disease NEC), I69.959 — Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting unspecified side (following, cerebrovascular disease), P11.9 — Birth injury to central nervous system, unspecified (newborn NEC, birth injury), P91.88 — Other specified disturbances of cerebral status of newborn (newborn NEC)

Contextual Map

Every relationship of G81.10 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 253 — Hemiplegia/Hemiparesis [CMS-HCC]: “Hemiplegia/Hemiparesis — supersedes HCC 254 (Monoplegia, Other Paralytic Syndromes)”— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 01 — Diseases and Disorders of the Nervous System[MDC crossing]: “Diseases and Disorders of the Nervous System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 8,919 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Nearest codes (18)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "G81.10 — Spastic hemiplegia affecting unspecified side." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/g81.10-spastic-hemiplegia-affecting-unspecified-side

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Spastic hemiplegia affecting unspecified side

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to G81.10 in its code family, with their registry titles.

View all codes in the G81 family