I69.261

HCC Category Mapping

What This Code Means

Various types of paralysis or muscle weakness affecting multiple areas of the body resulting from bleeding in the brain, on the right side which is the person's dominant side.

Coding Tips

• •This code is used for paralytic syndromes that don't fit the specific patterns of monoplegia or hemiplegia
• •Verify documentation describes the specific pattern of paralysis to ensure this 'other' category is appropriate

Clinical Significance

Other paralytic syndrome as a sequela of a nontraumatic intracranial hemorrhage other than intracerebral (such as subarachnoid or subdural hemorrhage) represents a chronic neurological deficit that significantly impacts the patient's functional status and ongoing care needs. This category captures paralytic syndromes that do not fit the specific monoplegia or hemiplegia patterns, such as locked-in syndrome, quadriplegia following stroke, or other complex motor deficits. These conditions represent significant risk adjustment value as they indicate severe neurological compromise with substantial ongoing care requirements.

Documentation Requirements

• ✓Documentation of prior other nontraumatic intracranial hemorrhage as the causative event with clear causal linkage to the current deficit
• ✓Confirmation that this is a sequela (late effect), not an acute or current cerebrovascular event
• ✓Specific description of the paralytic syndrome that does not fit monoplegia or hemiplegia categories
• ✓Current functional status and extent of paralytic involvement
• ✓Documentation of which side is affected (right or left)
• ✓Documentation of patient's hand dominance to determine dominant vs non-dominant classification
• ✓Current treatment plan including rehabilitation services, medications, and adaptive equipment
• ✓Assessment that the condition is being actively monitored or managed during the encounter

Commonly Confused Codes