G81.12: Spastic hemiplegia affecting left dominant side

G81.12, spastic hemiplegia affecting left dominant side, is listed as a covered diagnosis in 22 Medicare billing and coding articles that apply to 56 HCPCS Level II codes, including J0585 (Injection, onabotulinumtoxina, 1 unit), J0588 (Injection, incobotulinumtoxin a, 1 unit), J0586 (Injection, abobotulinumtoxina, 5 units). 4 of these codes have a 2026 DMEPOS fee schedule amount; E0783 pays $9,917.33 to $11,667.45 (NU) depending on the state. The articles come from 7 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with G81.12 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J0585Injection, onabotulinumtoxina, 1 unitSpecial coverage instructions apply—8
J0588Injection, incobotulinumtoxin a, 1 unitCarrier judgment—8
J0586Injection, abobotulinumtoxina, 5 unitsCarrier judgment—8
J0587Injection, rimabotulinumtoxinb, 100 unitsSpecial coverage instructions apply—8
J0589Injection, daxibotulinumtoxina-lanm, 1 unitCarrier judgment—8
C8900Magnetic resonance angiography with contrast, abdomenSpecial coverage instructions apply—2
C8901Magnetic resonance angiography without contrast, abdomenSpecial coverage instructions apply—2
C8902Magnetic resonance angiography without contrast followed by with contrast, abdomenSpecial coverage instructions apply—2
C8909Magnetic resonance angiography with contrast, chest (excluding myocardium)Special coverage instructions apply—2
C8910Magnetic resonance angiography without contrast, chest (excluding myocardium)Special coverage instructions apply—2
C8911Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)Special coverage instructions apply—2
C8912Magnetic resonance angiography with contrast, lower extremitySpecial coverage instructions apply—2
C8913Magnetic resonance angiography without contrast, lower extremitySpecial coverage instructions apply—2
C8914Magnetic resonance angiography without contrast followed by with contrast, lower extremitySpecial coverage instructions apply—2
C8918Magnetic resonance angiography with contrast, pelvisSpecial coverage instructions apply—2
C8919Magnetic resonance angiography without contrast, pelvisSpecial coverage instructions apply—2
C8920Magnetic resonance angiography without contrast followed by with contrast, pelvisSpecial coverage instructions apply—2
C8931Magnetic resonance angiography with contrast, spinal canal and contentsSpecial coverage instructions apply—2
C8932Magnetic resonance angiography without contrast, spinal canal and contentsSpecial coverage instructions apply—2
C8933Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contentsSpecial coverage instructions apply—2
C8934Magnetic resonance angiography with contrast, upper extremitySpecial coverage instructions apply—2
C8935Magnetic resonance angiography without contrast, upper extremitySpecial coverage instructions apply—2
C8936Magnetic resonance angiography without contrast followed by with contrast, upper extremitySpecial coverage instructions apply—2
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of careCarrier judgment—3
G0278Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure)Carrier judgment—1

31 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing G81.12

7 more articles list G81.12.

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other G81 diagnoses (Hemiplegia and hemiparesis)

Frequently asked questions

Does Medicare cover G81.12 (Spastic hemiplegia affecting left dominant side)?

Medicare covers items and services, not diagnoses. 22 Medicare billing and coding articles list G81.12 as a covered diagnosis for 56 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 G81.12?

The Level II codes from the policies most specific to this diagnosis are J0585 (Injection, onabotulinumtoxina, 1 unit, 8 articles); J0588 (Injection, incobotulinumtoxin a, 1 unit, 8 articles); J0586 (Injection, abobotulinumtoxina, 5 units, 8 articles); J0587 (Injection, rimabotulinumtoxinb, 100 units, 8 articles); J0589 (Injection, daxibotulinumtoxina-lanm, 1 unit, 8 articles). Code choice depends on the item supplied; check each code's descriptor.

What does Medicare pay for equipment billed with G81.12?

Under the 2026 DMEPOS fee schedule (non-rural state fees): E0783 $9,917.33 to $11,667.45 (NU); E0786 $10,969.75 to $11,380.88 (NU); E0782 $5,200.92 to $6,118.73 (NU); E0785 $572.38 to $673.39 (KF). Medicare pays 80% of the allowed amount after the Part B deductible.

Which Medicare policy articles list G81.12?

A57715 (Billing and Coding: Botulinum Toxins); A58423 (Billing and Coding: Botulinum Toxins); A57185 (Billing and Coding: Botulinum Toxin Injections), and 19 more articles.

What is ICD-10-CM code G81.12?

G81.12 is the ICD-10-CM code for spastic hemiplegia affecting left dominant side, in category G81 (Hemiplegia and hemiparesis), chapter 6: Diseases of the nervous system.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 6: Diseases of the nervous system · All diagnoses · HCPCS lookup