Is I69.054 a billable ICD-10-CM code?

Yes. I69.054 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does I69.054 sit in the tabular list?

Diseases of the circulatory system (I00-I99), in the block Cerebrovascular diseases (I60-I69).

What cannot be coded together with I69.054?

I69.054 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above I69.054 (I69) and apply to it just the same.

I69.054

I69.054 — Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left non-dominant side

Billable / specific codeICD-10-CMPOA exemptleft

I69.054 is a billable, specific ICD-10-CM code for hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left non-dominant side. It is valid for submission on a claim.

Excludes1 inherited from the categories above I69.054

These are not written on I69.054, but they bind it: a note on a category applies to every code beneath it. Billing I69.054 with anything listed here is a denial.

Written on I69 — Sequelae of cerebrovascular disease

personal history of cerebral infarction without residual deficit (Z86.73)
personal history of prolonged reversible ischemic neurologic deficit (PRIND) (Z86.73)
personal history of reversible ischemic neurologcial deficit (RIND) (Z86.73)
sequelae of traumatic intracranial injury (S06.-)

Other codes that can never be billed with I69.054

These codes carry an Excludes1 note pointing at I69.054. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I69.054 alone.

Z86.73Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits

Risk adjustment

I69.054 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 253 Hemiplegia/Hemiparesis0.387 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

I69.054 is named in 19 Medicare coverage policies — 19 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52992Billing and Coding: Non-Invasive Cerebrovascular Arterial Studies
A53057Billing and Coding: Home Health Occupational Therapy
A53058Billing and Coding: Home Health Physical Therapy
A53064Billing and Coding: Outpatient Occupational Therapy

Code history

I69.054 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share I69.05. If I69.054 is not quite right, the correct code is usually one of these.

Questions about I69.054

Is I69.054 a billable ICD-10-CM code?: Yes. I69.054 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does I69.054 sit in the tabular list?: Diseases of the circulatory system (I00-I99), in the block Cerebrovascular diseases (I60-I69).
What cannot be coded together with I69.054?: I69.054 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above I69.054 (I69) and apply to it just the same.