232: CEREBRAL PALSY

CONDITION/DISORDER SYNONYM

• Cerebral palsy (CP)

ICD-9-CM CODES

• 343 Infantile cerebral palsy

• 343.0 Congenital diplegia

• 343.1 Congenital hemiplegia

• 343.2 Congenital quadriplegia

• 343.3 Congenital monoplegia

• 343.4 Infantile hemiplegia

• 343.8 Other specified cerebral palsy

• 343.9 Infantile cerebral palsy, unspecified

ICD-10-CM CODES

• G80.0 Spastic quadriplegic cerebral palsy

• G80.1 Spastic diplegic cerebral palsy

• G80.2 Spastic hemiplegic cerebral palsy

• G80.3 Athetoid cerebral palsy

• G80.4 Ataxic cerebral palsy

• G80.8 Other cerebral palsy

• G80.9 Cerebral palsy, unspecified

PREFERRED PRACTICE PATTERN

• 5C: Impaired Motor Function and Sensory Integrity Associated with Nonprogressive Disorders of the Central Nervous System-–Congenital Origin in Infancy or Childhood¹

KEY FEATURES

Description

• Nonprogressive damage to cerebral cortex (and other parts of the brain, such as cerebellum) that occurs during prenatal, perinatal, or postnatal period²

Essentials of Diagnosis

• Four types of muscle tone (and percentage occurrence in children with CP)³

  • Hypotonia

  • Hypertonia (70%–75%)

  • Ataxia (10%–15%)

  • Athetosis (20%)

• Distribution of muscle tone

  • Quadriplegia: All four limbs involved, arms more than legs; cervical area, oral area

  • Diplegia: Primarily legs involved⁴

  • Hemiplegia: Primarily ipsilateral arm and leg involved⁴

  • Monoplegia: Only one limb involved

  • Triplegia: Only three limbs involved

  • In athetosis and ataxia, most often total body distribution: No hemiplegia, diplegia

• Gross motor function classification system⁵

  • Level I (least involved)

  • Level II

  • Level III

  • Level IV (most involved)

General Considerations

• Muscle tone often presents as hypotonia but changes before 12 months of age, most often to hypertonia depending on the type of CP

• Infants (under age 12 months) can also have “transient” muscle tone within first year of life; may initially present as hypertonic but resolves spontaneously without development of CP

• Associated disorders

  • Seizure disorder (in 50% of CP cases)³

  • Cognitive impairment (in 53% of CP cases)

  • Orthopedic deformities

  • Sensory integration dysfunction

  • Speech and language deficits

  • Difficulty feeding

  • Microcephaly³

  • Respiratory distress

  • Bronchopulmonary dysplasia⁶

  • Hydrocephalus³

  • Retinopathy of prematurity⁷

  • Visual impairment

  • Auditory impairment

    ...