2021 ICD-10-CM Diagnosis Code I69.359 Hemiplegia and hemiparesis following cerebral infarction affecting unspecified side 2016 2017 2018 2019 2020 2021 Billable/Specific Code POA Exempt I69.359 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
The patient above had a CVA with residual right side hemiparesis, and then later had another acute CVA. You then would code both the appropriate I63 code and the I69.351 for the sequela of the earlier stroke.
Assesment: CVA with left sided weakness (unspecified dominant or nondominate sided) The definition of hemiparesis is the partial paralysis of one side of the body, not weakness. From the medical dictionary and stroke.about.com, the following are defined:
In ICD-10 CM, code category I63 should be utilized when the medical documentation indicates that an infarction or stroke has occurred. Coding of sequelae of stroke and infarction also demands a level of detail often missing in medical records.
If a physician clearly documents that a patient is being seen who has a history of cerebrovascular disease or accident with residual effects, a code from category I69* should be assigned.
I69. 354 - Hemiplegia and hemiparesis following cerebral infarction affecting left non-dominant side | ICD-10-CM.
Cognitive deficits following cerebral infarction The 2022 edition of ICD-10-CM I69. 31 became effective on October 1, 2021. This is the American ICD-10-CM version of I69. 31 - other international versions of ICD-10 I69.
Coding Guidelines Residual neurological effects of a stroke or cerebrovascular accident (CVA) should be documented using CPT category I69 codes indicating sequelae of cerebrovascular disease. Codes I60-67 specify hemiplegia, hemiparesis, and monoplegia and identify whether the dominant or nondominant side is affected.
Other sequelae of cerebral infarction I69. 398 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM I69. 398 became effective on October 1, 2021.
Hemiparesis is a mild or partial weakness or loss of strength on one side of the body. Hemiplegia is a severe or complete loss of strength or paralysis on one side of the body. The difference between the two conditions primarily lies in severity.
Residual symptoms after transient ischaemic attack (TIA) The symptoms of a TIA are similar to that of stroke, but they may only last a short while, certainly no more than 24 hours. If symptoms last longer than 24 hours but are mild usually this would be defined as a 'minor stroke'.
Z86. 73 - Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits | ICD-10-CM.
Unspecified sequelae of cerebral infarction I69. 30 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM I69. 30 became effective on October 1, 2021.
Cerebral Infarction (Sequela) Hemiplegia is defined as paralysis of partial or total body function on one side of the body, whereas hemiparesis is characterized by one‐sided weakness, but without complete paralysis.
In ICD-10 CM, code category I63 should be utilized when the medical documentation indicates that an infarction or stroke has occurred.
Sequelae are residual effects or conditions produced after the acute phase of an illness or injury has ended. Therefore there is no time limit on when a sequela code can be assigned. Residuals may be apparent early on such as in cerebral infarction, or they can occur months or years later.....
I documented “left side weakness d/t CVA.” Why did this not risk adjust? “Weakness” is code 728.87 ICD-9, M62. 81 ICD-10, which is NOT A HCC. “Weakness” is a symptom, whereas “paresis” including monoparesis, hemiparesis and even quadriparesis are diagnoses.
Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting left dominant side. I69. 952 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM I69.
I69. 351 - Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side. ICD-10-CM.
Injury to the left side of the brain, which controls language and speaking, can result in right-sided weakness. Left-sided weakness results from injury to the right side of the brain, which controls nonverbal communication and certain behaviors.
Approximate Synonyms. Hemiparesis/hemiplegia (one sided weakness/paralysis) Hemiplegia and hemiparesis of left nondominant side as late effect of cerebrovascular disease. Left hemiplegia and hemiparesis due to cerebrovascular disease of non-dominant side. Present On Admission.
The 2022 edition of ICD-10-CM I69.954 became effective on October 1, 2021.
sequelae of traumatic intracranial injury ( S06.-) sequelae of traumatic intracranial injury ( S06.-) Hemiplegia and hemiparesis of left nondominant side as late effect of cerebrovascular disease. Left hemiplegia and hemiparesis due to cerebrovascular disease of non-dominant side.
The 2022 edition of ICD-10-CM I69.359 became effective on October 1, 2021.
Sequelae of cerebral infarction. Approximate Synonyms. Hemiparesis/hemiplegia (one sided weakness/paralysis) Hemiplegia (paralysis on one side), due to stroke. Hemiplegia (paralysis) and hemiparesis (weakness) from stroke. Hemiplegia (paralysis) from stroke. Hemiplegia and hemiparesis as late effect of embolic cerebrovascular accident.
Hemiplegia and hemiparesis G81-. This category is to be used only when hemiplegia (complete) (incomplete) is reported without further specification, or is stated to be old or longstanding but of unspecified cause.
Severe or complete loss of motor function on one side of the body; this condition is usually caused by brain diseases that are localized to the cerebral hemisphere opposite to the side of weakness; less frequently, brain stem lesions; cervical spinal cord diseases, peripheral nervous system diseases, and other conditions may manifest as hemiplegia. ...
Less frequently, brain stem lesions; cervical spinal cord diseases; peripheral nervous system diseases; and other conditions may manifest as hemiplegia. The term hemiparesis (see paresis) refers to mild to moderate weakness involving one side of the body.
The 2022 edition of ICD-10-CM Z86.73 became effective on October 1, 2021.
Z77-Z99 Persons with potential health hazards related to family and personal history and certain conditions influencing health status
The 2022 edition of ICD-10-CM I69.398 became effective on October 1, 2021.
Category I69 is to be used to indicate conditions in I60 - I67 as the cause of sequelae. The 'sequelae' include conditions specified as such or as residuals which may occur at any time after the onset of the causal condition. Type 1 Excludes.
In the encoder I put late/effect/CVA/hemiplegia/ unspecified (because it doesn't say whether left side was dominant or not. The code comes up 438.20 and tabular confirms Hemiplegia/hemipararesis (Late effect of CVA).
Go with 438.89. Look at the tip under 438.89 in the ICD-9 expert. Use 728.87 as your secondary code for residual weakness due to CVA.
In ICD-10 CM, code category I63 should be utilized when the medical documentation indicates that an infarction or stroke has occurred. Coding of sequelae of stroke and infarction also demands a level of detail often missing in medical records. There are specific codes which indicate the cause of the infarction, such as embolism or thrombosis, as well as the specific affected arteries. The sixth digit provides additional information which designates the affected side when applicable.
Seek answers to two questions when coding a stroke, infarction, or hemorrhage. First, ask if the cerebral event is acute, or emergent. Second, find in the medical record details of the site and the site, laterality, and type of stroke or infarction. Medical record documentation should clearly specify the cause-and-effect relationship between the medical intervention and the cerebrovascular accident in order to assign a code for an intraoperative or postprocedural cerebrovascular accident.
If a patient has a history of a past cerebrovascular event and has no residual sequelae, report Z86.73 Personal history of transient ischemic attack (TIA ), and cerebral infarction without residual deficits.
The patient is admitted into hospital and diagnosed with cerebral infarction, unspecified ( ICD-10 code I63.9). At the 3-week post-discharge follow-up appointment for the cerebral infarction, the office visit note states the patient had a stroke and has a residual deficit of hemiplegia, affecting the right dominant side.
Also code any documented atrial fibrillation, CAD, diabetes, or hypertension as these comorbidities are stroke risk factors.
If the provider is not specific in recording the site of a stroke or infarction, it is permissible for coders to use the accompanying CT scans or other radiological reports to report the specific anatomic site.
Documentation of unilateral weakness in conjunction with a stroke is considered by the ICD to be hemiparesis/hemiplegia due to the stroke and should be reported separately. Hemiparesis is not considered a normal sign or symptom of stroke and is always reported separately. If the patient’s dominant side is not documented, ...