ICD-10 Coding for Quadriplegia(G82.50, R53.2)
Complete ICD-10-CM coding and documentation guide for Quadriplegia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Quadriplegia
G82.5-G82.59Primary Range
Quadriplegia and tetraplegia
This range includes codes for structural quadriplegia resulting from spinal cord injuries or brainstem trauma.
Functional quadriplegia
This code is used for functional quadriplegia, indicating immobility due to severe physical disability or frailty.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G82.50 | Quadriplegia, unspecified | Use when quadriplegia results from a confirmed spinal cord injury. |
|
| R53.2 | Functional quadriplegia | Use when quadriplegia is due to immobility from conditions like advanced dementia. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for quadriplegia
Essential facts and insights about Quadriplegia
Primary ICD-10-CM Codes for quadriplegia
Decision Criteria
clinical Criteria
- Presence of spinal cord injury confirmed by imaging
coding Criteria
- Excludes functional quadriplegia
Applicable To
- Structural paralysis from spinal cord injury
Excludes
- Functional quadriplegia (R53.2)
Clinical Validation Requirements
- MRI or CT showing cervical spinal cord injury
Code-Specific Risks
- Confusion with functional quadriplegia
Coding Notes
- Ensure documentation specifies the cause of quadriplegia to avoid misclassification.
R53.2 - Functional quadriplegia
Use when quadriplegia is due to immobility from conditions like advanced dementia.
Applicable To
- Immobility due to severe disability
Excludes
- Neurologic quadriplegia (G82.5-)
Clinical Validation Requirements
- Documentation of total care needs and underlying conditions like dementia
Coding Notes
Ensure documentation includes the underlying condition causing immobility.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Immobilization syndrome
M62.3Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Quadriplegia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G82.50.
Impact
Clinical: Leads to incomplete patient records., Regulatory: May result in non-compliance with coding standards., Financial: Affects reimbursement accuracy.
Mitigation Strategy
Use templates to ensure all necessary information is documented.
Impact
Reimbursement: Incorrect coding can lead to improper DRG assignment., Compliance: May result in audit denials., Data Quality: Affects the accuracy of patient records.
Mitigation Strategy
Verify the cause of quadriplegia through clinical documentation before coding.
Impact
Lack of specific cause documentation can trigger audits.
Mitigation Strategy
Ensure all quadriplegia cases have documented etiology.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Quadriplegia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Quadriplegia
Use these documentation templates to ensure complete and accurate documentation for Quadriplegia. These templates include all required elements for proper coding and billing.
Advanced dementia with functional quadriplegia
Specialty: GeriatricsRequired Elements
- Total care needs
- Underlying condition
- Immobility documentation
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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