G81.00: Flaccid hemiplegia affecting unspecified side

Risk adjustment

G81.00 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

• HCC 253 Hemiplegia/Hemiparesis0.387 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

G81.00 is named in 3 Medicare coverage policies: 3 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

• A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
• A56551Billing and Coding: Visual Fields Testing
• A57668Billing and Coding: Nerve Conduction Studies and Electromyography