R53.2: Functional quadriplegia
R53.2 is a billable, specific ICD-10-CM code for functional quadriplegia. It is valid for submission on a claim.
Check R53.2 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.
- Complete immobility due to severe physical disability or frailty
Other codes that can never be billed with R53.2
Their own Excludes1 notes name this code, so the conflict is not listed above.
- G82Paraplegia (paraparesis) and quadriplegia (quadriparesis)
Risk adjustment
R53.2 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
R53.2 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56619Billing and Coding: Nerve Conduction Studies and Electromyography
Alphabetic index entries that lead here
- Immobile, immobility›complete, due to severe physical disability or frailty
- Quadriplegia›functional
Code history
Unchanged in every release from FY2024 to FY2027.