G83.4: Cauda equina syndrome
G83.4 is a billable, specific ICD-10-CM code for cauda equina syndrome. It is valid for submission on a claim.
Check G83.4 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Neurogenic bladder due to cauda equina syndrome
Other codes that can never be billed with G83.4
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
G83.4 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 182 Spinal Cord Disorders/Injuries0.478 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
G83.4 is named in 18 Medicare coverage policies: 18 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53058Billing and Coding: Home Health Physical Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
Alphabetic index entries that lead here
- Compression›cauda equina
- Lesion›cauda equina
- Syndrome›cauda equina
- Neurogenic›bladder›cauda equina syndrome
- Syndrome›compression›cauda equina
Code history
Unchanged in every release from FY2024 to FY2027.