G04.1 Tropical spastic paraplegia

Billable ICD-10-CM code, FY2026. Acts as a Complication or Comorbidity (CC) as a secondary diagnosis.

Applies from G04 Encephalitis, myelitis and encephalomyelitis

Includes

• acute ascending myelitis
• meningoencephalitis
• meningomyelitis

Excludes1 (never code together)

• encephalopathy NOS (G93.40)

Excludes2 (not included here)

• acute transverse myelitis (G37.3)
• alcoholic encephalopathy (G31.2)
• multiple sclerosis (G35-)
• myalgic encephalomyelitis (G93.32)
• subacute necrotizing myelitis (G37.4)
• toxic encephalitis (G92.8)
• toxic encephalopathy (G92.8)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 182 — Spinal Cord Disorders/Injuries
• CMS-HCC V22: HCC 72 — Spinal Cord Disorders/Injuries
• RxHCC V08: HCC 155 — Spinal Cord Disorders
• ESRD V24: HCC 72

MS-DRG index

Defines the logic of DRG(s) 052-053 in MDC 01.

Approximate ICD-9-CM (GEMs)

• 344.1 Paraplegia (approximate)

Code annotations containing back-references to G04.1

Back-references to G04

• Type 1 Excludes: G03 Meningitis due to other and unspecified causes ("meningoencephalitis (G04.-)")
• Type 1 Excludes: G03 Meningitis due to other and unspecified causes ("meningomyelitis (G04.-)")
• Type 2 Excludes: G95 Other and unspecified diseases of spinal cord ("myelitis (G04.-)")

Diagnosis Index entries for G04.1

• Paraplegia (lower) › spastic › tropical
• Paraplegia (lower) › tropical spastic

Nearby codes

• G04 Encephalitis, myelitis and encephalomyelitis
• G04.0 Acute disseminated encephalitis and encephalomyelitis (ADEM)
• G04.00 Acute disseminated encephalitis and encephalomyelitis, unspecified
• G04.01 Postinfectious acute disseminated encephalitis and encephalomyelitis (postinfectious ADEM)
• G04.02 Postimmunization acute disseminated encephalitis, myelitis and encephalomyelitis
• G04.1 Tropical spastic paraplegia (this code)
• G04.2 Bacterial meningoencephalitis and meningomyelitis, not elsewhere classified
• G04.3 Acute necrotizing hemorrhagic encephalopathy
• G04.30 Acute necrotizing hemorrhagic encephalopathy, unspecified
• G04.31 Postinfectious acute necrotizing hemorrhagic encephalopathy
• G04.32 Postimmunization acute necrotizing hemorrhagic encephalopathy