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G82.20

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🧬 ICD-10 CM G82.20 — Paraplegia, Unspecified

Billable Code Confirmed

ICD-10 CM G82.20 is a valid, billable 5-character ICD-10-CM code for FY2025. All five characters are present: G82 (category) + .2 (paraplegia) + 0 (unspecified). No additional characters are required.

Non-Billable Parent Codes — Never Submit These

  • ❌ G82 — 3-character header — missing impairment specification

  • ❌ G82.2 — 4-character header — missing complete/incomplete specification

    Always submit G82.20 (all 5 characters) when paraplegia is documented but the completeness of the lesion is not specified.

Clinical Context: "Unspecified" vs. Complete/Incomplete

ICD-10 CM G82.20 is used when a patient has paralysis of both lower limbs, but the provider has not documented whether the paraplegia is complete (total loss of sensory and motor function below the level of injury) or incomplete (some sensory or motor function is preserved). Whenever possible, query the provider for the exact functional status to use the more specific codes G82.21 (Complete) or G82.22 (Incomplete).

🔍 Code Description

ICD-10 CM G82.20 classifies paraplegia where the clinical completeness of the spinal cord lesion is not specified in the medical record.

Paraplegia is the impairment or loss of motor and/or sensory function in the lower half of the body, including the lower limbs, and often the pelvic organs and lower trunk, secondary to damage of the neural elements within the spinal canal (thoracic, lumbar, or sacral regions).

Common underlying etiologies include:

  • Trauma: Spinal cord injuries (SCI) from motor vehicle accidents, falls, or penetrating trauma.
  • Disease: Multiple sclerosis, transverse myelitis, spinal tumors, or infections (e.g., epidural abscess).
  • Vascular: Spinal cord infarction/ischemia.
  • Congenital: Spina bifida.

Note

Category G82 is intended for use when the paralytic condition is reported without further specification, or is stated to be old or longstanding. For acute injuries, the acute spinal cord injury code (S- series) is sequenced first.

🌳 Code Tree / Hierarchy

G82 Paraplegia (paraparesis) and quadriplegia (quadriparesis)
│  
├── G82.2 Paraplegia ❌ Non-billable
│ │  
│ ├── G82.20 PARAPLEGIA, UNSPECIFIED ◀ THIS CODE ✅
│ ├── G82.21 Paraplegia, complete
│ └── G82.22 Paraplegia, incomplete

✅ Includes

The following clinical scenarios and terms map to G82.20:

  • Paraplegia NOS
  • Paralysis of both lower limbs, unspecified whether complete or incomplete
  • Paraparesis (lower) NOS

❌ Excludes

Excludes1 — Cannot be coded together

The Excludes1 note dictates that the following conditions cannot be coded alongside G82.20 if referring to the same condition:

Code First / Code Also Notes

If the paraplegia is caused by a known underlying condition, the ICD-10-CM Official Guidelines require you to:

  • Code first the underlying cause (e.g., spinal cord neoplasm, multiple sclerosis, spina bifida, or acute traumatic spinal cord injury).
  • Use G82.20 as an additional code to identify the resulting paralytic syndrome.

🛠️ CPT Procedural Crosswalk — wRVU & Assistant Payable Status

Patients with paraplegia frequently require extensive physical medicine, rehabilitation, and spasticity management. Below are common procedural CPT codes paired with G82.20.

CPT CodeDescriptionwRVU (Facility)Asst. Surgeon Payable?Co-Surgeon Payable?
97110Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises0.65No (Indicator 0)No (Indicator 0)
97112Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation0.65No (Indicator 0)No (Indicator 0)
97542Wheelchair management (e.g., assessment, fitting, training), each 15 minutes0.59No (Indicator 0)No (Indicator 0)
62367Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (e.g., Baclofen pump); without reprogramming0.45No (Indicator 0)No (Indicator 0)
62368Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion; with reprogramming0.68No (Indicator 0)No (Indicator 0)

Note: wRVU values are estimates based on the standard CMS Physician Fee Schedule. Check current year exact values.

💊 Coding Scenarios

Scenario 1 — Outpatient PM&R for Long-Standing Paraplegia

Clinical Vignette: A 45-year-old male presents to the Physical Medicine and Rehabilitation clinic for ongoing spasticity management and wheelchair seating evaluation. He has a 10-year history of paraplegia secondary to a remote T12 burst fracture. The provider notes “Patient is paraplegic, functionally independent in manual wheelchair” but does not specify ASIA impairment scale or complete vs. incomplete status. The physician evaluates his seating pressure distribution and adjusts his baclofen pump.

CPT / HCPCS:

  • 62368 — Electronic analysis of programmable pump, with reprogramming
  • 97542 — Wheelchair management, 15 minutes

ICD-10-CM:

  • S32.009S — Unspecified fracture of unspecified lumbar vertebra, sequela (Captures the late effect/remote injury)
  • G82.20 — Paraplegia, unspecified (Identifies the neurologic deficit)
  • Z46.89 — Encounter for fitting and adjustment of other specified devices (For wheelchair)

Scenario 2 — Acute Traumatic Spinal Cord Injury (Inpatient)

Clinical Vignette: A 22-year-old female is admitted to the neurotrauma ICU following a high-speed MVC. Imaging reveals a complete transection of the spinal cord at T10. The neurosurgeon documents “Acute traumatic complete paraplegia secondary to T10 spinal cord laceration.”

Action / Outcome:

Using G82.20 as the primary code is incorrect for an acute injury, and the “unspecified” status is wrong since “complete” was documented.

Corrected ICD-10-CM Coding:

  • S24.113A — Complete lesion at T11-T12 level of thoracic spinal cord, initial encounter (Principal diagnosis: the acute injury)
  • G82.21 — Paraplegia, complete (Secondary diagnosis: the resulting paralysis)

Scenario 3 — CDI Query: Specifying Paraplegia Type

Clinical Vignette: A primary care provider documents “Follow-up for paraplegia due to old MVA. Patient has some retained sensation in his right foot but no motor movement.” The coder initially prepares to assign G82.20 for “paraplegia.”

Action / Outcome:

Because the documentation mentions retained sensation below the level of injury, this clinically indicates an incomplete spinal lesion. However, the exact word “incomplete” wasn’t explicitly stated in the diagnosis line. The coder should query the provider to confirm “Incomplete paraplegia” to assign the highest specificity code.

Corrected ICD-10-CM Coding (Post-Query Confirmation):

  • G82.22 — Paraplegia, incomplete

⚠️ Coding Pitfalls and Tips

Pitfall or Tip
❌Do not use G82 codes as primary for acute trauma: If the paraplegia is due to a current, acute spinal cord injury, the injury code from Chapter 19 (e.g., S14-, S24-, S34-) must be sequenced first.
❌Do not confuse with hemiplegia or quadriplegia: Ensure the paralysis is confined to the lower half of the body. If one side of the body (arm and leg) is paralyzed, use hemiplegia (G81.9-). If all four limbs are involved, use quadriplegia (G82.50).
✅Query for Complete vs. Incomplete: Always review neuro exams or PM&R notes for “ASIA Scale” grades. ASIA A is complete (G82.21), while ASIA B, C, or D represent incomplete injuries (G82.22). If absent, query the provider to move away from the unspecified G82.20 code.
✅Look for related secondary conditions: Patients with long-standing paraplegia often suffer from related conditions that should be coded if treated/monitored, such as neurogenic bladder (N31.9), pressure ulcers (L89.-), or muscle spasms (M62.838).

📚 Sources

  1. CMS/NCHS. ICD-10-CM Official Guidelines for Coding and Reporting, FY2025. Tabular List — G82.20 Paraplegia, unspecified. Chapter 6 Guidelines (Nervous System).

  2. American Medical Association (AMA). CPT 2024/2025 Professional Edition. Physical Medicine and Rehabilitation; Central Nervous System Assessments/Tests.

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