I69.365
I69.365: Other paralytic syndrome following cerebral infarction, bilateral
Billable / specific codeICD-10-CMPOA exemptbilateral
I69.365 is a billable, specific ICD-10-CM code for other paralytic syndrome following cerebral infarction, bilateral. It is valid for submission on a claim.
Check I69.365 with the rest of the claim: free scrubberOther codes that can never be billed with I69.365
Their own Excludes1 notes name this code, so the conflict is not listed above.
- Z86.73Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits
Risk adjustment
I69.365 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
I69.365 is named in 9 Medicare coverage policies: 9 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A53057Billing and Coding: Home Health Occupational Therapy
- A53058Billing and Coding: Home Health Physical Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
- A54095Billing and Coding: Nerve Conduction Studies and Electromyography
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under I69.36
- I69.361Other paralytic syndrome following cerebral infarction affecting right dominant side
- I69.362Other paralytic syndrome following cerebral infarction affecting left dominant side
- I69.363Other paralytic syndrome following cerebral infarction affecting right non-dominant side
- I69.364Other paralytic syndrome following cerebral infarction affecting left non-dominant side
- I69.369Other paralytic syndrome following cerebral infarction affecting unspecified side