2027 ICD-10-CM Diagnosis Code G83.5Locked-in state
ICD-10-CM Codes›G00–G99›G80-G83›G83
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Risk Adjusts — HCC 254
- Chronic Condition
G83.5 is a billable ICD-10-CM diagnosis code for locked-in state. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 91 through 93. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 70 closely related codes. Coders also document this condition as locked in syndrome. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Paralysis (other than cerebral palsy).
For Medicare Advantage risk adjustment, G83.5 maps to CMS-HCC Category 254 (Monoplegia, Other Paralytic Syndromes) under the V28 model, adding a risk factor of about 0.321 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
G83.5 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.
- Locked in syndrome
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to G83.5: its own notes plus those printed at G83 and Chapter 6. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
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 the listed conditions are reported without further specification, or are stated to be old or longstanding but of unspecified cause. The category is also for use in multiple coding to identify these conditions resulting from any cause.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name G83.5, its category, or a range that includes it.
Use Additional Code 6
These codes say to use an additional code from the note, and G83.5 is one of the codes named.
- I69.06 Other paralytic syndrome following nontraumatic subarachnoid hemorrhagelocked-in state (G83.5)
- I69.16 Other paralytic syndrome following nontraumatic intracerebral hemorrhagelocked-in state (G83.5)
- I69.26 Other paralytic syndrome following other nontraumatic intracranial hemorrhagelocked-in state (G83.5)
- I69.36 Other paralytic syndrome following cerebral infarctionlocked-in state (G83.5)
- I69.86 Other paralytic syndrome following other cerebrovascular diseaselocked-in state (G83.5)
- I69.96 Other paralytic syndrome following unspecified cerebrovascular diseaselocked-in state (G83.5)
Index to Diseases and InjuriesGuidance
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Locked-In State
a rare neurologic disorder caused by an insult to the brainstem. it is characterized by quadriplegia, bulbar palsy, and sensory loss. however, level of consciousness, cognition, hearing, eye movements and blinking may be preserved.
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 G83.5 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About G83.5Overview
What is the ICD-10 code for locked-in state?
The ICD-10-CM code for locked-in state is G83.5 (sometimes written as G835). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is G83.5 (Other paralytic syndromes) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report locked-in state on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does G83.5 group to?
When locked-in state is the principal diagnosis on an inpatient stay, it groups to MS-DRG 91, 92, 93, with relative weights from 0.7783 to 1.7050 depending on complications. Higher weights mean higher Medicare reimbursement.
Is G83.5 a CC or MCC?
CMS lists G83.5 as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 70 closely related codes in its exclusion list.
What is the ICD-9 equivalent of G83.5?
Under the General Equivalence Mappings, locked-in state converts to ICD-9-CM 344.81 (locked-in state). The mapping is a direct match.
What HCC is G83.5?
G83.5 (locked-in state) maps to CMS-HCC Category 254 (Monoplegia, Other Paralytic Syndromes), commonly written as HCC 254, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 104 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.
Does G83.5 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, G83.5 adds a risk adjustment factor of about 0.321 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.000 to 0.365 depending on the payment segment). A more severe related category (HCC 180, HCC 181, HCC 191, HCC 192, and HCC 253) supersedes it when both are reported. See the full factor table on the HCC 254 category page.
