G11.4 — Hereditary spastic paraplegia
G11.4 is a billable, specific ICD-10-CM code for hereditary spastic paraplegia. It is valid for submission on a claim.
Other codes that can never be billed with G11.4
These codes carry an Excludes1 note pointing at G11.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading G11.4 alone.
- G80Cerebral palsy
Risk adjustment
G11.4 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 200 Friedreich and Other Hereditary Ataxias; Huntington Disease0.279 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
G11.4 is named in 33 Medicare coverage policies — 33 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
- A54095Billing and Coding: Nerve Conduction Studies and Electromyography
How G11.4 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to G11.4.
- Ataxia, ataxy, ataxic›spastic hereditary
- Paraplegia›familial spastic
- Paraplegia›hereditary, spastic
- Ataxia, ataxy, ataxic›hereditary›spastic
- Paralysis, paralytic›familial›spastic
- Paralysis, paralytic›spastic›familial
- Paralysis, paralytic›spastic›hereditary
- Paraplegia›spastic›hereditary
Related codes at this level
Codes that share G11. If G11.4 is not quite right, the correct code is usually one of these.
- G11.0Congenital nonprogressive ataxia
- G11.1Early-onset cerebellar ataxia
- G11.2Late-onset cerebellar ataxia
- G11.3Cerebellar ataxia with defective DNA repair
- G11.5Hypomyelination - hypogonadotropic hypogonadism - hypodontia
- G11.6Leukodystrophy with vanishing white matter disease
- G11.8Other hereditary ataxias
- G11.9Hereditary ataxia, unspecified
Questions about G11.4
- Is G11.4 a billable ICD-10-CM code?
- Yes. G11.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does G11.4 sit in the tabular list?
- Diseases of the nervous system (G00-G99), in the block Systemic atrophies primarily affecting the central nervous system (G10-G14).