What is ICD-10 code I69.054?

I69.054 is the ICD-10-CM diagnosis code for Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left non-dominant side. It belongs to the ICD-10-CM chapter for diseases of the circulatory system (i00-i99). I69.054 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I69.054 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. I69.054 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. I69.054 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 I69.054?

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 I69.054, V28 maps to Hemiplegia/Hemiparesis at RAF 0.000 while V24 mapped to Hemiplegia/Hemiparesis at RAF 0.447. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting I69.054?

Confirm left side is documented as non-dominant to ensure correct code assignment This code indicates sequela status; the original hemorrhage event should be documented in patient history Because I69.054 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.

I69.054 ICD-10 Code: Hemiplegia and hemiparesis

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 lookupI69.054Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

I69.054

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

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

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

Buddy Insight

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

CMS-HCC V28

Mapped

HCC 253

Hemiplegia/Hemiparesis

RAF 0.0

CMS-HCC V24

Mapped

HCC 103

Hemiplegia/Hemiparesis

RAF 0.447

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 103

Hemiplegia/Hemiparesis

RAF 0.0

RXHCC

Not risk-adjusted for this model/period.

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

I69.054Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left non-dominant side

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I69.054 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I69.054 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

I69.053Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right 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 I69.054 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I69.054 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I69.054 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I69.054 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I69.054 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 I69.054 an HCC code?

Yes. I69.054 maps to Hemiplegia/Hemiparesis under the CMS-HCC V28 risk adjustment model (and Hemiplegia/Hemiparesis under V24).

HCC Category Mapping

V28HCC 253, Hemiplegia/Hemiparesis

0.000

V24HCC 103, Hemiplegia/Hemiparesis

0.447

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.

MEAT Criteria for I69.054

For I69.054to 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 I69.054 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

I69.054 is the ICD-10-CM diagnosis code for hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left non-dominant side. Weakness or complete paralysis affecting one entire side of the body on the left side that is the person's non-dominant side, occurring as a long-term effect of bleeding in the brain (subarachnoid hemorrhage). I69.054 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, I69.054 maps to Hemiplegia/Hemiparesis (HCC 253) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, I69.054 mapped to the same category but with a base RAF weight of 0.447, 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.

Confirm left side is documented as non-dominant to ensure correct code assignment. Because I69.054 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 I69.054 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Confirm left side is documented as non-dominant to ensure correct code assignment
•This code indicates sequela status; the original hemorrhage event should be documented in patient history

Clinical Significance

This code captures hemiplegia/hemiparesis (left 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