Is I69.242 a billable ICD-10-CM code?

Yes. I69.242 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does I69.242 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 I69.242?

I69.242 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 I69.242 (I69) and apply to it just the same.

I69.242

I69.242 — Monoplegia of lower limb following other nontraumatic intracranial hemorrhage affecting left dominant side

Billable / specific codeICD-10-CMPOA exemptleft

I69.242 is a billable, specific ICD-10-CM code for monoplegia of lower limb following other nontraumatic intracranial hemorrhage affecting left dominant side. It is valid for submission on a claim.

Excludes1 inherited from the categories above I69.242

These are not written on I69.242, but they bind it: a note on a category applies to every code beneath it. Billing I69.242 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 I69.242

These codes carry an Excludes1 note pointing at I69.242. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I69.242 alone.

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

Risk adjustment

I69.242 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 254 Monoplegia, Other Paralytic Syndromes0.321 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

I69.242 is named in 18 Medicare coverage policies — 18 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

I69.242 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 I69.24. If I69.242 is not quite right, the correct code is usually one of these.

Questions about I69.242

Is I69.242 a billable ICD-10-CM code?: Yes. I69.242 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does I69.242 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 I69.242?: I69.242 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 I69.242 (I69) and apply to it just the same.