Is G81.13 a billable ICD-10-CM code?

Yes. G81.13 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does G81.13 sit in the tabular list?

Diseases of the nervous system (G00-G99), in the block Cerebral palsy and other paralytic syndromes (G80-G83).

What cannot be coded together with G81.13?

G81.13 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above G81.13 (G81) and apply to it just the same.

G81.13

G81.13 — Spastic hemiplegia affecting right nondominant side

Billable / specific codeICD-10-CMright

G81.13 is a billable, specific ICD-10-CM code for spastic hemiplegia affecting right nondominant side. It is valid for submission on a claim.

Excludes1 inherited from the categories above G81.13

These are not written on G81.13, but they bind it: a note on a category applies to every code beneath it. Billing G81.13 with anything listed here is a denial.

Written on G81 — Hemiplegia and hemiparesis

congenital cerebral palsy (G80.-)
hemiplegia and hemiparesis due to sequela of cerebrovascular disease (I69.05-, I69.15-, I69.25-, I69.35-, I69.85-, I69.95-)

Risk adjustment

G81.13 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.

Medicare coverage

G81.13 is named in 56 Medicare coverage policies — 56 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52992Billing and Coding: Non-Invasive Cerebrovascular Arterial Studies
A53057Billing and Coding: Home Health Occupational Therapy
A53058Billing and Coding: Home Health Physical Therapy
A53064Billing and Coding: Outpatient Occupational Therapy

Code history

G81.13 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share G81.1. If G81.13 is not quite right, the correct code is usually one of these.

Questions about G81.13

Is G81.13 a billable ICD-10-CM code?: Yes. G81.13 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does G81.13 sit in the tabular list?: Diseases of the nervous system (G00-G99), in the block Cerebral palsy and other paralytic syndromes (G80-G83).
What cannot be coded together with G81.13?: G81.13 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above G81.13 (G81) and apply to it just the same.