ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 G31.87

Billable / Specific HCC v28: 52

Primary progressive apraxia of speech

G31
Block
0
Synonyms
303
LCDs
15
Payer Policies
4
Linked CPTs

About ICD-10-CM G31.87

ICD-10-CM code G31.87 represents Primary progressive apraxia of speech. This is a billable/specific code in the Nervous System chapter (block G31). The 2026 edition of ICD-10-CM G31.87 became effective on October 1, 2025.

Coding Tips for G31.87

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

G31.87 is a CMS-HCC v28 risk-adjustment code (category 52). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 52
ESRD-HCC
Category 52

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Medicare LCD Coverage for G31.87

Local Coverage Determinations (LCDs) from CMS MACs that list G31.87 as a covered diagnosis.

303 LCDs

Showing top 10 of 303 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92524 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 96112 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92521 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97130 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97129 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92597 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97110 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 97533 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 96110 →
CMS LCD: Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Article ID: 54111, Effective: 2025-10-01 00:00:00, 1064 covered, 0 non-covered
CPT 92522 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing G31.87.

15 policies

3 Cigna

Airway Clearance Devices in the Ambulatory Setting - (0069)
Policy ID: MM_0069
Duplex Scan of Extracranial Arteries - (0542)
Policy ID: MM_0542
Serum Folate and Red Blood Cell Folate Testing - (0567)
Policy ID: MM_0567

5 Medicare

Billing and Coding: Home Health Speech-Language Pathology
Policy ID: ART-53052
Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
Policy ID: ART-54111
Billing and Coding: CT of the Head
Policy ID: ART-56612
Billing and Coding: Hospice Alzheimer's Disease & Related Disorders
Policy ID: ART-56639
Billing and Coding: Home Health Skilled Nursing Care-Teaching and Training: Alzheimer's Disease and Behavioral Disturbances
Policy ID: ART-56641

CPT Codes Commonly Billed with G31.87

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

4 linkages
  • G0161 CMS LCD: Billing and Coding: Home Health Speech-Language Pathology CMS LCD
  • G0153 CMS LCD: Billing and Coding: Home Health Speech-Language Pathology CMS LCD
  • G0539 CMS LCD: Billing and Coding: Home Health Skilled Nursing Care-Teaching and Training: Alzheimer's Disease and Behavioral Disturbances CMS LCD
  • G0540 CMS LCD: Billing and Coding: Home Health Skilled Nursing Care-Teaching and Training: Alzheimer's Disease and Behavioral Disturbances CMS LCD

ICD-10 G31.87, Billing FAQ

Is ICD-10 code G31.87 billable? +

Yes, G31.87 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does G31.87 affect Medicare Advantage HCC risk adjustment? +

Yes. G31.87 maps to CMS-HCC v28 category 52. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with G31.87? +

Procedures frequently paired with G31.87 include: G0161, G0153, G0539, G0540.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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