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I69.352 ICD-10-CM Code: Hemiplegia and hemiparesis following cerebral infarction affecting left dominant side

I69.352 maps to CMS-HCC V28 253. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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

I69.352

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

Hemiplegia and hemiparesis following cerebral infarction affecting left dominant side

Weakness or paralysis affecting one entire side of the body (arm and leg together) on the left side after a stroke, in a person whose dominant side is the left.

Buddy the Bee presenting code insight

Buddy Insight

Hemiplegia and hemiparesis as a sequela of a cerebral infarction (ischemic stroke) represents a chronic neurological deficit that significantly impacts the patient's functional status and ongoing care needs.

CMS-HCC V28

HCC 253

Code-level coefficient reference

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 150

Code-level coefficient reference

ESRD/PACE

HCC 103

Code-level coefficient reference

RXHCC

N/A

Not mapped

Code Book Path

Official
I69.3Sequelae of cerebral infarction
I69.35Hemiplegia and hemiparesis following cerebral infarction
I69.352Hemiplegia and hemiparesis following cerebral infarction affecting left dominant side

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I69.352 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I69.352 in this effective period.

Related Child Codes

Official
I69.351Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side
I69.353Hemiplegia and hemiparesis following cerebral infarction affecting right non-dominant side
I69.354Hemiplegia and hemiparesis following cerebral infarction affecting left non-dominant side
I69.359Hemiplegia and hemiparesis following cerebral infarction affecting unspecified side

Includes

Official

ICD-10-CM does not list Includes notes for I69.352 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I69.352 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I69.352 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I69.352 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I69.352 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Documentation of prior cerebral infarction (stroke) 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
Description of hemiplegia or hemiparesis affecting one entire side of the body (both upper and lower extremities)
Current functional status and severity of the hemiplegia/hemiparesis (complete vs incomplete paralysis)

MEAT Support

HCC Buddy guidance
Documentation of prior cerebral infarction (stroke) 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
Description of hemiplegia or hemiparesis affecting one entire side of the body (both upper and lower extremities)
Current functional status and severity of the hemiplegia/hemiparesis (complete vs incomplete paralysis)

Audit Caution

HCC Buddy guidance
Using an acute cerebrovascular code (I60-I63) instead of a sequela code (I69) when the event occurred in a prior encounter
Coding monoplegia when both upper and lower limbs on the same side are affected — this should be coded as hemiplegia
Confusing hemiplegia (paralysis) with hemisensory loss or hemineglect, which require different codes
Incorrectly assigning dominant vs non-dominant side — if handedness is not documented, the default assumption is right-hand dominance per ICD-10-CM guidelines

Common Mistakes

HCC Buddy guidance
I69.1/I69.2/I69.8xx codes — sequelae of different cerebrovascular event types; must match the documented causative event
G81.x (Hemiplegia and hemiparesis, not specified as sequela) — use G81 when not a sequela of cerebrovascular disease
I69.x5x vs I69.x4x (Monoplegia of lower limb) — hemiplegia affects an entire side, not just one limb
Dominant vs non-dominant side codes — verify patient handedness; left-handed patients have left dominant side, right-handed have left non-dominant

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 I69.352 an HCC code?

Yes. I69.352 (Hemiplegia and hemiparesis following cerebral infarction affecting left dominant side) maps to HCC 253, Hemiplegia/Hemiparesis under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.387. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: I69.352 is billable and maps to V28 HCC 253, Hemiplegia/Hemiparesis. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
I69.352
Description
Hemiplegia and hemiparesis following cerebral infarction affecting left dominant side
HCC (V28)
HCC 253 — Hemiplegia/Hemiparesis
RAF reference coefficient
0.387
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 253, Hemiplegia/Hemiparesis
0.387
ESRDHCC 103, Hemiplegia/Hemiparesis
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work I69.352 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for I69.352

For I69.352 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 I69.352 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

I69.352 is the ICD-10-CM diagnosis code for hemiplegia and hemiparesis following cerebral infarction affecting left dominant side. Weakness or paralysis affecting one entire side of the body (arm and leg together) on the left side after a stroke, in a person whose dominant side is the left. I69.352 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, I69.352 maps to Hemiplegia/Hemiparesis (HCC 253) with a source-labeled community, non-dual, aged reference coefficient of 0.387. No V24 mapping is shown for I69.352; use the applicable model and payment year when reviewing the V28 mapping. 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. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Use I69.352 when the provider wording supports hemiplegia and hemiparesis following cerebral infarction affecting left dominant side. Check the FY2026 tabular notes and the full code path before the final code choice. Because I69.352 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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, source-labeled coefficient references, and MEAT documentation criteria for I69.352 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Use I69.352 when the provider wording supports hemiplegia and hemiparesis following cerebral infarction affecting left dominant side. Check the FY2026 tabular notes and the full code path before the final code choice.
  • For this DOS, capture the provider's current assessment and the care action documented for hemiplegia and hemiparesis following cerebral infarction affecting left dominant side. Keep the checklist tied to the note.
  • Do not swap I69.352 with I69.351. The FY2026 tabular describes I69.351 as hemiplegia and hemiparesis following cerebral infarction affecting right dominant side. Follow the documented detail.
  • I69.352 maps to V28 HCC 253, Hemiplegia/Hemiparesis. The mapping does not replace the documentation review. The code still has to match the note.
  • Ask Buddy to show the official notes for I69.352 or compare its code path with I69.351.

Clinical Significance

Hemiplegia and hemiparesis as a sequela of a cerebral infarction (ischemic stroke) represents a chronic neurological deficit that significantly impacts the patient's functional status and ongoing care needs. Hemiplegia involves paralysis or significant weakness affecting one entire side of the body, requiring ongoing rehabilitation, fall prevention strategies, and often assistive devices for activities of daily living. This condition is a key risk adjustment indicator as it reflects severe neurological damage with high resource utilization for therapy, home health, and durable medical equipment.

Documentation Requirements

  • Documentation of prior cerebral infarction (stroke) 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
  • Description of hemiplegia or hemiparesis affecting one entire side of the body (both upper and lower extremities)
  • Current functional status and severity of the hemiplegia/hemiparesis (complete vs incomplete paralysis)
  • 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

  • I69.1/I69.2/I69.8xx codes: sequelae of different cerebrovascular event types; must match the documented causative event
  • G81.x (Hemiplegia and hemiparesis, not specified as sequela): use G81 when not a sequela of cerebrovascular disease
  • I69.x5x vs I69.x4x (Monoplegia of lower limb): hemiplegia affects an entire side, not just one limb
  • Dominant vs non-dominant side codes: verify patient handedness; left-handed patients have left dominant side, right-handed have left non-dominant

Child Codes

Code Hierarchy

Because I69.352 maps to an HCC category, the documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment.

I69.352 maps to CMS-HCC V28 category 253, Hemiplegia/Hemiparesis. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for I69.352. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

More on I69.352

Related condition guides

Work I69.352 in HCC Buddy

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