What is ICD-10 code I69.039?

I69.039 is the ICD-10-CM diagnosis code for Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting unspecified side. Weakness or paralysis of one arm after a spontaneous brain bleed when the specific side or dominance status is not documented. I69.039 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I69.039 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. I69.039 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. I69.039 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for I69.039?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For I69.039, V28 maps to Monoplegia, Other Paralytic Syndromes at RAF 0.000 while V24 mapped to Monoplegia, Other Paralytic Syndromes at RAF 0.304. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting I69.039?

Use this code only when laterality and dominance cannot be determined from documentation Query provider if possible to obtain more specific information for accurate coding Because I69.039 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

I69.039 ICD-10 Code: Monoplegia of upper limb

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupI69.039Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Cerebrovascular diseases (I60-I69)

I69.039

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting unspecified side

Weakness or paralysis of one arm after a spontaneous brain bleed when the specific side or dominance status is not documented.

Buddy Insight

This code captures monoplegia of the upper limb (unspecified side) as a late effect (sequela) of a prior nontraumatic subarachnoid hemorrhage.

CMS-HCC V28

Mapped

HCC 254

Monoplegia, Other Paralytic S...

RAF 0.0

CMS-HCC V24

Mapped

HCC 104

Monoplegia, Other Paralytic S...

RAF 0.304

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 104

Monoplegia, Other Paralytic S...

RAF 0.0

RXHCC

Not risk-adjusted for this model/period.

RAF 0

Code Trumping

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Compare selected patient codes to show trumped or trumps impact.

Code Book Path

Official

I69.0Sequelae of nontraumatic subarachnoid hemorrhage

I69.03Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage

I69.039Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting unspecified side

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I69.039 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I69.039 in this effective period.

Related Child Codes

Official

I69.031Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting right dominant side

I69.032Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting left dominant side

I69.033Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting right non-dominant side

I69.034Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting left non-dominant side

Includes

Official

ICD-10-CM does not list Includes notes for I69.039 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I69.039 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I69.039 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I69.039 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I69.039 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Clear documentation of monoplegia as a current, active condition (not just historical)

Documentation linking the paralytic deficit to a prior nontraumatic subarachnoid hemorrhage

Specification of affected side and dominance (right dominant, left dominant, right non-dominant, left non-dominant)

Current functional status assessment and impact on activities of daily living

MEAT Support

HCC Buddy guidance

Clear documentation of monoplegia as a current, active condition (not just historical)

Documentation linking the paralytic deficit to a prior nontraumatic subarachnoid hemorrhage

Specification of affected side and dominance (right dominant, left dominant, right non-dominant, left non-dominant)

Current functional status assessment and impact on activities of daily living

Audit Caution

HCC Buddy guidance

Coding an acute stroke code (I60.x) instead of the sequela code (I69.0x) — sequelae codes are for residual deficits from a prior event, not the acute stroke itself

Failing to specify laterality and dominance — the 5th and 6th characters indicate affected side and whether it is the dominant or non-dominant side

Confusing subarachnoid hemorrhage sequelae (I69.0x) with intracerebral hemorrhage sequelae (I69.1x) — different underlying stroke types

Not recapturing the sequela code annually — these are chronic conditions that should be reported each year the deficit persists

Common Mistakes

HCC Buddy guidance

I69.04x — Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage; different limb affected

I69.05x — Hemiplegia/hemiparesis following nontraumatic subarachnoid hemorrhage; involves both arm and leg on one side

I69.13x — Monoplegia of upper limb following nontraumatic intracerebral hemorrhage; different type of hemorrhagic stroke

I69.33x — Monoplegia of upper limb following cerebral infarction; sequela of ischemic, not hemorrhagic stroke

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is I69.039 an HCC code?

Yes. I69.039 maps to Monoplegia, Other Paralytic Syndromes under the CMS-HCC V28 risk adjustment model (and Monoplegia, Other Paralytic Syndromes under V24).

HCC Category Mapping

V28HCC 254, Monoplegia, Other Paralytic Syndromes

0.000

V24HCC 104, Monoplegia, Other Paralytic Syndromes

0.304

ESRDHCC 104, Monoplegia, Other Paralytic Syndromes

0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

MEAT Criteria for I69.039

For I69.039to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed I69.039 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

I69.039 is the ICD-10-CM diagnosis code for monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting unspecified side. Weakness or paralysis of one arm after a spontaneous brain bleed when the specific side or dominance status is not documented. I69.039 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering cerebrovascular diseases (i60-i69).

Under the CMS-HCC V28 risk adjustment model, I69.039 maps to Monoplegia, Other Paralytic Syndromes (HCC 254) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, I69.039 mapped to the same category but with a base RAF weight of 0.304, V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Use this code only when laterality and dominance cannot be determined from documentation. Because I69.039 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for I69.039 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code only when laterality and dominance cannot be determined from documentation
•Query provider if possible to obtain more specific information for accurate coding

Clinical Significance

This code captures monoplegia of the upper limb (unspecified side) as a late effect (sequela) of a prior nontraumatic subarachnoid hemorrhage. Monoplegia affecting a single limb following subarachnoid hemorrhage reflects residual neurological damage from the original hemorrhagic stroke. Accurate capture of stroke sequelae is essential for risk adjustment, as these chronic deficits indicate ongoing care needs including rehabilitation, assistive devices, and increased fall risk.

Documentation Requirements

✓Clear documentation of monoplegia as a current, active condition (not just historical)
✓Documentation linking the paralytic deficit to a prior nontraumatic subarachnoid hemorrhage
✓Specification of affected side and dominance (right dominant, left dominant, right non-dominant, left non-dominant)
✓Current functional status assessment and impact on activities of daily living
✓Ongoing treatment plan (physical therapy, occupational therapy, medications for spasticity)
✓Documentation that the original stroke was a subarachnoid hemorrhage specifically (not intracerebral hemorrhage or cerebral infarction)

Commonly Confused Codes

•I69.04x: Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage; different limb affected
•I69.05x: Hemiplegia/hemiparesis following nontraumatic subarachnoid hemorrhage; involves both arm and leg on one side
•I69.13x: Monoplegia of upper limb following nontraumatic intracerebral hemorrhage; different type of hemorrhagic stroke
•I69.33x: Monoplegia of upper limb following cerebral infarction; sequela of ischemic, not hemorrhagic stroke
•G83.2x: Monoplegia of upper limb; use when cause is not stroke sequela