2027 ICD-10-CM Diagnosis Code G81.11Spastic hemiplegia affecting right dominant side
ICD-10-CM Codes›G00–G99›G80-G83›G81
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 253
- Chronic Condition
G81.11 is a billable ICD-10-CM diagnosis code for spastic hemiplegia affecting right dominant side. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 56 through 57. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 138 closely related codes. Coders also document this condition as hemiplegia of right dominant side. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Paralysis (other than cerebral palsy).
For Medicare Advantage risk adjustment, G81.11 maps to CMS-HCC Category 253 (Hemiplegia/Hemiparesis) under the V28 model, adding a risk factor of about 0.387 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
G81.11 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Hemiplegia of right dominant side
- Right hemiplegia
- Spastic hemiplegia
- Spastic hemiplegia of dominant side
- Spastic hemiplegia of right dominant side
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to G81.11: its own notes plus those printed at G81 and Chapter 6. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Notes
General instructions on how these codes are used.
- This category is to be used only when hemiplegia (complete)(incomplete) is reported without further specification, or is stated to be old or longstanding but of unspecified cause. The category is also for use in multiple coding to identify these types of hemiplegia resulting from any cause.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Spastic Hemiplegia
a type of spastic cerebral palsy characterized by increased muscle tone of the arm and leg on the same side of the body.
Patient EducationClinical
Paralysis
Paralysis is the loss of muscle function in part of your body. It happens when something goes wrong with the way messages pass between your brain and muscles. Paralysis can be complete or partial. It can occur on one or both sides of your body. It can also occur in just one area, or it can be widespread.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert G81.11 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About G81.11Overview
What is the ICD-10 code for spastic hemiplegia affecting right dominant side?
The ICD-10-CM code for spastic hemiplegia affecting right dominant side is G81.11 (sometimes written as G8111). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is G81.11 (Spastic hemiplegia) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report spastic hemiplegia affecting right dominant side on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does G81.11 group to?
When spastic hemiplegia affecting right dominant side is the principal diagnosis on an inpatient stay, it groups to MS-DRG 57, 56, with relative weights from 1.2835 to 2.2649 depending on complications. Higher weights mean higher Medicare reimbursement.
Is G81.11 a CC or MCC?
CMS lists G81.11 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 138 closely related codes in its exclusion list.
Can G81.11 be reported with a code from G80?
Not as a rule. The Excludes1 note at G81, which applies to G81.11, lists "congenital cerebral palsy (G80.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What HCC is G81.11?
G81.11 (spastic hemiplegia affecting right dominant side) maps to CMS-HCC Category 253 (Hemiplegia/Hemiparesis), commonly written as HCC 253, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 103 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 207.
Does G81.11 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, G81.11 adds a risk adjustment factor of about 0.387 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.000 to 0.437 depending on the payment segment). A more severe related category (HCC 180, HCC 191, and HCC 192) supersedes it when both are reported. See the full factor table on the HCC 253 category page.
