2025 ICD-10-CM code I69.85
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the circulatory system - Sequelae of other cerebrovascular diseases Chapter 9: Diseases of the circulatory system (I00-I99) Feed
Hemiplegia and hemiparesis following other cerebrovascular disease.
Medical necessity for continued care is established by the persistent effects of the cerebrovascular event, evidenced by ongoing neurological deficits (hemiplegia or hemiparesis) requiring rehabilitation, medication management, or other therapeutic interventions.
Neurologists, physiatrists, and other specialists involved in the rehabilitation and management of stroke patients are primarily responsible for the care and coding associated with this diagnosis.The initial event might require the attention of other specialties depending on the cause and type.
- Chapter 9: Diseases of the circulatory system (I00-I99)
- I69.85 is a sub-category under I69 (Sequelae of cerebrovascular disease), which is further nested within Chapter 9 (Diseases of the circulatory system).
In simple words: This code is for weakness or paralysis on one side of the body that happened after a stroke or other blood vessel problem in the brain, but not from the specific types of stroke listed in other codes.
This code classifies hemiplegia (paralysis affecting one side of the body) and hemiparesis (weakness affecting one side of the body) that occur as a consequence of cerebrovascular diseases other than those specifically listed in codes I60-I67.The underlying cerebrovascular event must have already occurred.This code is used to denote the residual effects,and it's crucial to code the initial cerebrovascular event separately if known.
Example 1: A 72-year-old patient presents with right-sided hemiparesis following a lacunar infarct (a small stroke) three months prior. The lacunar infarct is coded separately, and I69.85 is used to reflect the persistent weakness., A 65-year-old patient experiences a hemorrhagic stroke and subsequently develops left-sided hemiplegia. After rehabilitation, the persistent hemiplegia is coded using I69.85, with the initial hemorrhagic stroke coded separately., A 50-year-old patient with a history of uncontrolled hypertension suffers a stroke and experiences right-sided hemiparesis.I69.85 is used to code the residual weakness, while I10 (hypertensive disease) is coded to reflect the contributing factor.
Detailed medical records must include documentation of the initial cerebrovascular event, the patient's neurological examination findings demonstrating hemiplegia or hemiparesis,and the time elapsed since the event.Imaging studies (CT scan, MRI) confirming the cerebrovascular event are crucial.Documentation should also address the patient's functional status and any rehabilitation interventions received.
** This code is not intended for transient neurological deficits or those that completely resolve.Always ensure the proper documentation supports the diagnosis of persistent hemiplegia or hemiparesis.
- Payment Status: Active
- Specialties:Neurology, Physical Medicine and Rehabilitation, Internal Medicine
- Place of Service:Inpatient Hospital, Outpatient Hospital, Skilled Nursing Facility, Rehabilitation Facility, Office