G83.5 — Locked-in state
G83.5 is a billable, specific ICD-10-CM code for locked-in state. It is valid for submission on a claim.
Risk adjustment
G83.5 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 254 Monoplegia, Other Paralytic Syndromes0.321 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
G83.5 is named in 16 Medicare coverage policies — 16 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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
How G83.5 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to G83.5.
- Locked-in state
- State›locked-in
Related codes at this level
Codes that share G83. If G83.5 is not quite right, the correct code is usually one of these.
Questions about G83.5
- Is G83.5 a billable ICD-10-CM code?
- Yes. G83.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does G83.5 sit in the tabular list?
- Diseases of the nervous system (G00-G99), in the block Cerebral palsy and other paralytic syndromes (G80-G83).