G81.94: Hemiplegia, unspecified affecting left nondominant side

Risk adjustment

G81.94 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

G81.94 is named in 34 Medicare coverage policies: 29 listing it as supporting medical necessity, and 5 listing it as NOT covered. Which one applies depends on your Medicare contractor.

• A57701Billing and Coding: Trigger Point Injections (TPI)not covered
• A59480Billing and Coding: Trigger Point Injections (TPI)not covered
• A59487Billing and Coding: Trigger Point Injections (TPI)not covered
• A59498Billing and Coding: Trigger Point Injections (TPI)not covered