I69.831

HCC Category Mapping

What This Code Means

Weakness or paralysis of one arm on the right side of the body (the dominant side) following a stroke or other brain blood vessel disease.

Coding Tips

• •Monoplegia indicates weakness/paralysis of a single limb; confirm dominance is right
• •Distinguish between dominant and non-dominant side based on patient's handedness documentation

Clinical Significance

Monoplegia of the upper limb as a sequela of other cerebrovascular disease not classified elsewhere represents a chronic neurological deficit that significantly impacts the patient's functional status and ongoing care needs. Upper limb monoplegia affects the patient's ability to perform fine motor tasks, self-care activities, and may require occupational therapy and adaptive equipment. Accurate capture of this sequela is important for risk adjustment as it reflects ongoing neurological impairment requiring continued medical management and rehabilitation services.

Documentation Requirements

• ✓Documentation of prior the specific cerebrovascular disease 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
• ✓Documentation that paralysis or weakness is isolated to one upper extremity (arm)
• ✓Current functional status of the affected upper limb including strength assessment
• ✓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