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.
Excludes1 inherited from the categories above I69.865
These are not written on I69.865, but they bind it: a note on a category applies to every code beneath it. Billing I69.865 with anything listed here is a denial.
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
These codes carry an Excludes1 note pointing at I69.865. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading I69.865 alone.
- 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.
Medicare coverage
I69.865 is named in 6 Medicare coverage policies — 6 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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
I69.865 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 I69.86. If I69.865 is not quite right, the correct code is usually one of these.
- 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
Questions about I69.865
- Is I69.865 a billable ICD-10-CM code?
- Yes. I69.865 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does I69.865 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 I69.865?
- I69.865 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 I69.865 (I69.86, I69.8, I69) and apply to it just the same.