I69.163 ICD-10-CM Code: Other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting right non-dominant side
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the circulatory system (I00-I99) / Cerebrovascular diseases (I60-I69)
I69.163
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther paralytic syndrome following nontraumatic intracerebral hemorrhage affecting right non-dominant side
Other types of muscle weakness or paralysis (beyond hemiplegia) on the right non-dominant side resulting from brain bleeding.
Buddy Insight
This code captures other paralytic syndrome (right non-dominant side) as a late effect of prior nontraumatic intracerebral hemorrhage.
CMS-HCC V28
MappedHCC 254
RAF 0.0
CMS-HCC V24
MappedHCC 104
RAF 0.304
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 104
RAF 0.0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for I69.163 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for I69.163 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for I69.163 in this effective period.
Excludes 1
Official- hemiplegia/hemiparesis following nontraumatic intracerebral hemorrhage (I69.15-)
- monoplegia of lower limb following nontraumatic intracerebral hemorrhage (I69.14-)
- monoplegia of upper limb following nontraumatic intracerebral hemorrhage (I69.13-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for I69.163 in this effective period.
Use Additional
Official- code to identify type of paralytic syndrome, such as:
- locked-in state (G83.5)
- quadriplegia (G82.5-)
Code Also
OfficialICD-10-CM does not list Code Also instructions for I69.163 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 I69.163 an HCC code?
Yes. I69.163 maps to Monoplegia, Other Paralytic Syndromes under the CMS-HCC V28 risk adjustment model (and Monoplegia, Other Paralytic Syndromes under V24).
HCC Category Mapping
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 I69.163
For I69.163to 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 I69.163 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
I69.163 is the ICD-10-CM diagnosis code for other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting right non-dominant side. Other types of muscle weakness or paralysis (beyond hemiplegia) on the right non-dominant side resulting from brain bleeding. I69.163 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, I69.163 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, I69.163 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.
Verify the distinction between dominant and non-dominant side is clearly documented. Because I69.163 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 I69.163 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the distinction between dominant and non-dominant side is clearly documented
- •Ensure the paralytic syndrome is a sequela of the intracerebral hemorrhage, not a separate condition
Clinical Significance
This code captures other paralytic syndrome (right non-dominant side) as a late effect of prior nontraumatic intracerebral hemorrhage. Other paralytic syndromes following intracerebral hemorrhage may include quadriplegia, locked-in syndrome, or complex multi-limb paralytic patterns. These represent severe neurological sequelae with high care requirements, and accurate coding ensures appropriate risk adjustment for the ongoing management burden.
Documentation Requirements
- ✓Clear documentation of other paralytic syndrome 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; use for single upper limb paralysis
- •I69.14x: Monoplegia of lower limb following nontraumatic intracerebral hemorrhage; use for single lower limb paralysis
- •I69.15x: Hemiplegia/hemiparesis following nontraumatic intracerebral hemorrhage; use for one-sided paralysis
- •I69.06x: Other paralytic syndrome following nontraumatic subarachnoid hemorrhage; different type of hemorrhagic stroke
- •G83.9: Paralytic syndrome, unspecified; use when cause is not stroke sequela