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I69.053 ICD-10-CM Code: Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right non-dominant side

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

I69.053

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

Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right non-dominant side

Weakness or complete paralysis affecting one entire side of the body on the right side that is the person's non-dominant side, occurring as a long-term effect of bleeding in the brain (subarachnoid hemorrhage).

Buddy the Bee presenting code insight

Buddy Insight

This code captures hemiplegia/hemiparesis (right non-dominant side) as a late effect of prior nontraumatic subarachnoid hemorrhage.

CMS-HCC V28

HCC 253

RAF 0.387

CMS-HCC V24

HCC 103

RAF 0.437

ACA/HHS

0

0

RAF 0

ESRD/PACE

HCC 103

RAF 0.0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
I69.0Sequelae of nontraumatic subarachnoid hemorrhage
I69.05Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage
I69.053Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right non-dominant side

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I69.053 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I69.053 in this effective period.

Related Child Codes

Official
I69.051Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right dominant side
I69.052Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left dominant side
I69.054Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left non-dominant side
I69.059Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting unspecified side

Includes

Official

ICD-10-CM does not list Includes notes for I69.053 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I69.053 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I69.053 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I69.053 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I69.053 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Clear documentation of hemiplegia/hemiparesis 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 hemiplegia/hemiparesis 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
I69.03x — Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage; affects only one limb, not the entire side
I69.04x — Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage; affects only one limb, not the entire side
I69.15x — Hemiplegia/hemiparesis following nontraumatic intracerebral hemorrhage; different type of hemorrhagic stroke
I69.35x — Hemiplegia/hemiparesis 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 I69.053 an HCC code?

Yes. I69.053 maps to Hemiplegia/Hemiparesis under the CMS-HCC V28 risk adjustment model (and Hemiplegia/Hemiparesis under V24).

HCC Category Mapping

V28HCC 253, Hemiplegia/Hemiparesis
0.387
V24HCC 103, Hemiplegia/Hemiparesis
0.437
ESRDHCC 103, Hemiplegia/Hemiparesis
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.

Work I69.053 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I69.053

For I69.053to 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 I69.053 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I69.053 is the ICD-10-CM diagnosis code for hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right non-dominant side. Weakness or complete paralysis affecting one entire side of the body on the right side that is the person's non-dominant side, occurring as a long-term effect of bleeding in the brain (subarachnoid hemorrhage). I69.053 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, I69.053 maps to Hemiplegia/Hemiparesis (HCC 253) with a community, non-dual, aged base RAF weight of 0.387. Under the older V24 model, I69.053 mapped to the same category but with a base RAF weight of 0.437, 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.

Document confirms right side is non-dominant to distinguish from I69.051. Because I69.053 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 I69.053 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Document confirms right side is non-dominant to distinguish from I69.051
  • Assign when patient has residual hemiplegia from prior subarachnoid hemorrhage event

Clinical Significance

This code captures hemiplegia/hemiparesis (right non-dominant side) as a late effect of prior nontraumatic subarachnoid hemorrhage. Hemiplegia (complete paralysis) or hemiparesis (partial weakness) of one side of the body is the most common and functionally devastating stroke sequela. This condition significantly impacts risk adjustment as it indicates high ongoing care needs including physical therapy, occupational therapy, assistive devices, and increased risk for falls, pressure injuries, and contractures.

Documentation Requirements

  • Clear documentation of hemiplegia/hemiparesis 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

  • I69.03x: Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage; affects only one limb, not the entire side
  • I69.04x: Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage; affects only one limb, not the entire side
  • I69.15x: Hemiplegia/hemiparesis following nontraumatic intracerebral hemorrhage; different type of hemorrhagic stroke
  • I69.35x: Hemiplegia/hemiparesis following cerebral infarction; sequela of ischemic, not hemorrhagic stroke
  • G81.9x: Hemiplegia, unspecified; use when cause is not stroke sequela

Child Codes

Code Hierarchy

Because I69.053 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.

I69.053 maps to CMS-HCC V28 category 253, Hemiplegia/Hemiparesis. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works.

More on I69.053

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