What is ICD-10 code I69.142?

I69.142 is the ICD-10-CM diagnosis code for Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting left dominant side. It belongs to the ICD-10-CM chapter for diseases of the circulatory system (i00-i99). I69.142 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I69.142 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. I69.142 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. I69.142 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.

Which HCC does I69.142 map to under V28?

I69.142 maps to CMS-HCC V28 254 (Monoplegia, Other Paralytic Syndromes). The category number and label come from the CMS-HCC V28 model file for payment year 2026.

What does I69.142 pay in RAF?

I69.142 carries a community, non-dual, aged (CNA) RAF weight of 0.321 under CMS-HCC V28 for payment year 2026. The weight comes from the CMS V28 relative-factor file, not a hand-typed table.

What is the V28 vs V24 difference for I69.142?

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 I69.142, V28 maps to Monoplegia, Other Paralytic Syndromes at RAF 0.321 while V24 mapped to Monoplegia, Other Paralytic Syndromes at RAF 0.331. Both models can still appear in legacy data and in payer-specific lookback periods.

2026 ICD-10-CM I69.142: Monoplegia of lower limb

I69.142 maps to CMS-HCC V28 254 (RAF 0.321). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC Buddy coding tools

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Code lookupI69.142Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

I69.142

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

Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting left dominant side

Weakness or paralysis of one leg on the left side of the body that occurred as a result of bleeding in the brain, where the left side is the person's dominant side.

Buddy Insight

This code captures monoplegia of the lower limb (left dominant side) as a late effect (sequela) of a prior nontraumatic intracerebral hemorrhage.

CMS-HCC V28

Mapped

HCC 254

Monoplegia, Other Paralytic S...

RAF 0.321

CMS-HCC V24

Mapped

HCC 104

Monoplegia, Other Paralytic S...

RAF 0.331

ACA/HHS

Mapped

HCC 151

HHS-HCC 151

Varies by metal level

ESRD/PACE

Mapped

HCC 104

Monoplegia, Other Paralytic S...

RAF 0.047

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

I69.1Sequelae of nontraumatic intracerebral hemorrhage

I69.14Monoplegia of lower limb following nontraumatic intracerebral hemorrhage

I69.142Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting left dominant side

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I69.142 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I69.142 in this effective period.

Related Child Codes

Official

I69.141Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting right dominant side

I69.143Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting right non-dominant side

I69.144Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting left non-dominant side

I69.149Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting unspecified side

Includes

Official

ICD-10-CM does not list Includes notes for I69.142 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I69.142 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I69.142 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I69.142 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I69.142 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Clear documentation of monoplegia as a current, active condition (not just in the patient's history)

Documentation explicitly linking the paralytic deficit to a prior nontraumatic intracerebral hemorrhage

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

Current functional assessment documenting the severity and impact on activities of daily living

MEAT Support

HCC Buddy guidance

Clear documentation of monoplegia as a current, active condition (not just in the patient's history)

Documentation explicitly linking the paralytic deficit to a prior nontraumatic intracerebral hemorrhage

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

Current functional assessment documenting the severity and impact on activities of daily living

Audit Caution

HCC Buddy guidance

Coding an acute intracerebral hemorrhage code (I61.x) instead of the sequela code (I69.1x) — sequelae codes are for residual deficits, not the acute event

Confusing intracerebral hemorrhage sequelae (I69.1x) with subarachnoid hemorrhage sequelae (I69.0x) or cerebral infarction sequelae (I69.3x)

Failing to specify laterality and dominance — the 5th and 6th characters capture this critical clinical detail

Not recapturing the sequela code annually — these chronic deficits must be reported each year they persist and are actively managed

Common Mistakes

HCC Buddy guidance

I69.13x — Monoplegia of upper limb following nontraumatic intracerebral hemorrhage; different limb affected

I69.15x — Hemiplegia/hemiparesis following nontraumatic intracerebral hemorrhage; involves both arm and leg on one side

I69.04x — Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage; different type of hemorrhagic stroke

I69.34x — Monoplegia of lower limb following cerebral infarction; sequela of ischemic, not hemorrhagic stroke

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is I69.142 an HCC code?

Yes. I69.142 (Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting left dominant side) maps to Monoplegia, Other Paralytic Syndromes under the CMS-HCC V28 risk adjustment model (and Monoplegia, Other Paralytic Syndromes under V24), with a community non-dual aged RAF of 0.321. It is billable for payment year 2026.

Coder answer: I69.142 is billable and maps to V28 HCC 254, Monoplegia, Other Paralytic Syndromes. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: I69.142
Description: Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting left dominant side
HCC (V28): HCC 254 — Monoplegia, Other Paralytic Syndromes
RAF: 0.321
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 254, Monoplegia, Other Paralytic Syndromes

0.321

V24HCC 104, Monoplegia, Other Paralytic Syndromes

0.331

ESRDHCC 104, Monoplegia, Other Paralytic Syndromes

0.047

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. 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 I69.142 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for I69.142

For I69.142 to 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 I69.142 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I69.142 is the ICD-10-CM diagnosis code for monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting left dominant side. Weakness or paralysis of one leg on the left side of the body that occurred as a result of bleeding in the brain, where the left side is the person's dominant side. I69.142 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, I69.142 maps to Monoplegia, Other Paralytic Syndromes (HCC 254) with a community, non-dual, aged base RAF weight of 0.321. Under the older V24 model, I69.142 mapped to the same category but with a base RAF weight of 0.331, 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.

Verify the hemorrhage location and resulting monoplegia are clearly documented in the medical record. Because I69.142 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 I69.142 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify the hemorrhage location and resulting monoplegia are clearly documented in the medical record
•Ensure dominance status is explicitly stated to differentiate from I69.144

Clinical Significance

This code captures monoplegia of the lower limb (left dominant side) as a late effect (sequela) of a prior nontraumatic intracerebral hemorrhage. Intracerebral hemorrhage often causes more severe and persistent neurological deficits than ischemic stroke due to direct brain tissue destruction. Capturing these sequelae accurately reflects the patient's ongoing functional limitations and care needs for risk adjustment purposes.

Documentation Requirements

✓Clear documentation of monoplegia as a current, active condition (not just in the patient's history)
✓Documentation explicitly linking the paralytic deficit to a prior nontraumatic intracerebral hemorrhage
✓Specification of affected side and dominance (right dominant, left dominant, right non-dominant, left non-dominant)
✓Current functional assessment documenting the severity and impact on activities of daily living
✓Ongoing treatment plan including rehabilitation services, medications, and assistive devices
✓Documentation that the original stroke was an intracerebral hemorrhage (bleeding within the brain tissue) — not subarachnoid hemorrhage or cerebral infarction

Commonly Confused Codes

•I69.13x: Monoplegia of upper limb following nontraumatic intracerebral hemorrhage; different limb affected
•I69.15x: Hemiplegia/hemiparesis following nontraumatic intracerebral hemorrhage; involves both arm and leg on one side
•I69.04x: Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage; different type of hemorrhagic stroke
•I69.34x: Monoplegia of lower limb following cerebral infarction; sequela of ischemic, not hemorrhagic stroke
•G83.1x: Monoplegia of lower limb; use when cause is not stroke sequela