I69.931

HCC Category Mapping

What This Code Means

Weakness or paralysis affecting only one arm on the right side of the body after a stroke, in a person whose right side is their dominant side.

Coding Tips

• •The fifth character (3) indicates upper limb monoplegia; the sixth character (1) specifies right dominant side
• •Document the patient's dominant hand and which side is affected to ensure accurate code selection

Clinical Significance

Monoplegia of the upper limb as a sequela of unspecified cerebrovascular disease represents a persistent neurological deficit requiring ongoing management, rehabilitation, and monitoring for functional decline. This diagnosis captures the long-term disability burden from cerebrovascular events and significantly impacts the patient's independence, fall risk, and need for assistive services. Accurate capture is essential for risk adjustment as it reflects the sustained resource utilization associated with post-stroke paralytic syndromes.

Documentation Requirements

• ✓Documentation of the specific type of prior cerebrovascular event (stroke, hemorrhage, or other cerebrovascular disease) that caused the sequela
• ✓Clear statement establishing a causal relationship between the prior cerebrovascular event and the current neurological deficit
• ✓Documentation that the condition is a late effect or sequela, not an acute or evolving stroke
• ✓Specification that the paralysis is isolated to one upper limb (monoplegia), not affecting an entire side of the body
• ✓Documentation of the affected side (right or left) AND whether it is the patient's dominant or non-dominant side
• ✓Current functional status assessment including impact on activities of daily living, mobility, and need for assistive devices or caregiver support
• ✓Ongoing treatment plan addressing the neurological deficit (physical therapy, occupational therapy, medications, or other interventions)

Commonly Confused Codes