G82.54: Quadriplegia, C5-C7 incomplete

Risk adjustment

G82.54 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

• HCC 180 Quadriplegia1.125 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

G82.54 is named in 33 Medicare coverage policies: 33 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

• A52494High Frequency Chest Wall Oscillation Devices - Policy Article
• A52510Mechanical In-exsufflation Devices - Policy Article
• A53057Billing and Coding: Home Health Occupational Therapy
• A53058Billing and Coding: Home Health Physical Therapy