G95.81
G95.81: Conus medullaris syndrome
Billable / specific codeICD-10-CM
G95.81 is a billable, specific ICD-10-CM code for conus medullaris syndrome. It is valid for submission on a claim.
Check G95.81 with the rest of the claim: free scrubberExcludes1 inherited from the categories above G95.81
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above G95.81
Not part of this code, but both may be coded when both are present.
Risk adjustment
G95.81 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
G95.81 is named in 15 Medicare coverage policies: 15 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A53065Billing and Coding: Outpatient Physical Therapy
- A54095Billing and Coding: Nerve Conduction Studies and Electromyography
Alphabetic index entries that lead here
- Conus›medullaris syndrome
- Syndrome›conus medullaris
Code history
Unchanged in every release from FY2024 to FY2027.