2025 ICD-10-CM code I69.05
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Cerebrovascular diseases - Sequelae of cerebrovascular disease Diseases of the circulatory system (I00-I99) Feed
Hemiplegia and hemiparesis following a nontraumatic subarachnoid hemorrhage.
Modifiers may be applicable depending on the circumstances of the care provided.Consult your specific payer guidelines for acceptable modifier usage in this context.
The medical necessity for coding I69.05 is established by the presence of hemiplegia or hemiparesis as a direct consequence of a documented nontraumatic subarachnoid hemorrhage. This requires appropriate diagnostic and clinical documentation.
Neurologists, physiatrists, and other specialists involved in the care of patients with neurological deficits are responsible for accurate documentation and coding of this condition.
In simple words: This code is for when someone has weakness or paralysis on one side of their body because of bleeding in their brain that wasn't caused by an injury.
This code classifies hemiplegia (paralysis of one side of the body) or hemiparesis (weakness of one side of the body) as a sequela (a condition that is a consequence of a previous disease or injury) of a nontraumatic subarachnoid hemorrhage (bleeding into the space between the brain and the tissue covering the brain).The hemorrhage must be nontraumatic in origin, meaning it was not caused by an injury.
Example 1: A 60-year-old female presents with sudden onset of left-sided weakness and paralysis following a diagnosed nontraumatic subarachnoid hemorrhage.Imaging studies confirm the hemorrhage and neurological deficits., A 72-year-old male experiences a nontraumatic subarachnoid hemorrhage resulting in right-sided hemiparesis.Physical therapy is initiated to improve his motor function., A 45-year-old female with a history of aneurysmal subarachnoid hemorrhage develops persistent hemiplegia affecting her left side, requiring ongoing rehabilitation and supportive care.
Detailed medical history, including the date and details surrounding the onset of the subarachnoid hemorrhage.Neurological examination findings documenting the presence and extent of hemiplegia or hemiparesis.Radiological imaging (CT scan, MRI) confirming the presence and location of the subarachnoid hemorrhage.Documentation supporting the non-traumatic nature of the hemorrhage.Progress notes and records of rehabilitation services.
** The laterality and dominance of the affected side should be specified using additional codes (I69.051-I69.054) when applicable. Always cross-reference with other relevant codes to ensure complete and accurate billing.
- Payment Status: Active
- Modifier TC rule: No Technical Component (TC) modifier is typically used with this diagnosis code as it is not a procedural code.
- Specialties:Neurology, Neurosurgery, Physical Medicine and Rehabilitation
- Place of Service:Inpatient Hospital, Outpatient Hospital, Skilled Nursing Facility, Rehabilitation Facility,Office