I69.865: Other paralytic syndrome following other cerebrovascular disease, bilateral
I69.865 is a billable, specific ICD-10-CM code for other paralytic syndrome following other cerebrovascular disease, bilateral. It is valid for submission on a claim.
Check I69.865 with the rest of the claim: free scrubberExcludes1 inherited from the categories above I69.865
A category’s note binds every code beneath it.
Written on I69.86: Other paralytic syndrome following other cerebrovascular disease
Written on I69.8: Sequelae of other cerebrovascular diseases
- sequelae of traumatic intracranial injury (S06.-)
Written on I69: Sequelae of cerebrovascular disease
Other codes that can never be billed with I69.865
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
I69.865 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
I69.865 is named in 6 Medicare coverage policies: 6 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
- A57130Billing and Coding: Psychiatric Codes
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under I69.86
- I69.861Other paralytic syndrome following other cerebrovascular disease affecting right dominant side
- I69.862Other paralytic syndrome following other cerebrovascular disease affecting left dominant side
- I69.863Other paralytic syndrome following other cerebrovascular disease affecting right non-dominant side
- I69.864Other paralytic syndrome following other cerebrovascular disease affecting left non-dominant side
- I69.869Other paralytic syndrome following other cerebrovascular disease affecting unspecified side