What is ICD-10 code I69.954?

I69.954 is the ICD-10-CM diagnosis code for Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting left non-dominant side. Paralysis or weakness affecting one entire side of the body following a stroke, occurring on the left side in a right-handed person. I69.954 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. I69.954 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. I69.954 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. I69.954 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for I69.954?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For I69.954, V28 maps to Hemiplegia/Hemiparesis at RAF 0.000 while V24 mapped to Hemiplegia/Hemiparesis at RAF 0.447. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting I69.954?

This represents a non-dominant side stroke; verify the patient's handedness is documented to distinguish from I69.952 Non-dominant hemisphere strokes may present with different neurological deficits than dominant side strokes Because I69.954 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

I69.954 ICD-10 Code: Hemiplegia and hemiparesis

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupI69.954Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

I69.954

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

Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting left non-dominant side

Paralysis or weakness affecting one entire side of the body following a stroke, occurring on the left side in a right-handed person.

Buddy Insight

CMS-HCC V28

Mapped

HCC 253

Hemiplegia/Hemiparesis

RAF 0.0

CMS-HCC V24

Mapped

HCC 103

Hemiplegia/Hemiparesis

RAF 0.447

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Mapped

HCC 103

Hemiplegia/Hemiparesis

RAF 0.0

RXHCC

Not risk-adjusted for this model/period.

RAF 0

Code Trumping

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Code Book Path

Official

I69.9Sequelae of unspecified cerebrovascular diseases

I69.95Hemiplegia and hemiparesis following unspecified cerebrovascular disease

I69.954Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting left non-dominant side

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for I69.954 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for I69.954 in this effective period.

Related Child Codes

Official

I69.951Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting right dominant side

I69.952Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting left dominant side

I69.953Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting right non-dominant side

I69.959Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting unspecified side

Includes

Official

ICD-10-CM does not list Includes notes for I69.954 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for I69.954 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for I69.954 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for I69.954 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for I69.954 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

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

Documentation specifying whether the deficit is complete paralysis (hemiplegia) or partial weakness (hemiparesis)

MEAT Support

HCC Buddy guidance

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

Documentation specifying whether the deficit is complete paralysis (hemiplegia) or partial weakness (hemiparesis)

Audit Caution

HCC Buddy guidance

Failing to differentiate between hemiplegia (complete paralysis) and hemiparesis (partial weakness) in documentation — while both map to the same code, the clinical distinction should be documented

Coding an acute cerebrovascular event when the condition is actually a sequela — I69.x codes are exclusively for late effects, not the initial stroke episode

Using the unspecified cerebrovascular disease sequela code when the medical record contains documentation of the specific type of cerebrovascular event — always query the provider or review historical records for the original diagnosis

Assuming right-handed dominance without documentation — the provider must explicitly state which side is dominant; if dominance is not documented, the default classification rules assign dominant to the right side and non-dominant to the left, but querying the provider is best practice

Common Mistakes

HCC Buddy guidance

I69.85x — Hemiplegia/hemiparesis following other cerebrovascular disease; use when the specific type of cerebrovascular disease is documented

I69.94x — Monoplegia of lower limb following unspecified cerebrovascular disease; use when only one limb is paralyzed, not the entire side

I69.93x — Monoplegia of upper limb following unspecified cerebrovascular disease; use when only one arm is paralyzed, not the entire side

G81.x — Hemiplegia unspecified as to cause; use when the hemiplegia is not documented as a sequela of cerebrovascular disease

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 I69.954 an HCC code?

Yes. I69.954 maps to Hemiplegia/Hemiparesis under the CMS-HCC V28 risk adjustment model (and Hemiplegia/Hemiparesis under V24).

HCC Category Mapping

V28HCC 253, Hemiplegia/Hemiparesis

0.000

V24HCC 103, Hemiplegia/Hemiparesis

0.447

ESRDHCC 103, Hemiplegia/Hemiparesis

0.000

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 I69.954

For I69.954to 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 I69.954 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

I69.954 is the ICD-10-CM diagnosis code for hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting left non-dominant side. Paralysis or weakness affecting one entire side of the body following a stroke, occurring on the left side in a right-handed person. I69.954 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, I69.954 maps to Hemiplegia/Hemiparesis (HCC 253) with a community, non-dual, aged base RAF weight of 0.000. Under the older V24 model, I69.954 mapped to the same category but with a base RAF weight of 0.447, 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.

This represents a non-dominant side stroke; verify the patient's handedness is documented to distinguish from I69.952. Because I69.954 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 I69.954 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This represents a non-dominant side stroke; verify the patient's handedness is documented to distinguish from I69.952
•Non-dominant hemisphere strokes may present with different neurological deficits than dominant side strokes

Clinical Significance

Hemiplegia and hemiparesis following unspecified cerebrovascular disease represents one of the most functionally devastating sequelae of stroke, affecting an entire side of the body and profoundly limiting mobility, self-care, and independence. This condition carries higher resource utilization than monoplegia due to the greater scope of neurological impairment and the need for intensive rehabilitation, durable medical equipment, and caregiver support. Accurate coding is critical for risk adjustment as hemiplegia maps to a higher-weighted HCC than monoplegia, reflecting its greater clinical severity.

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
✓Documentation specifying whether the deficit is complete paralysis (hemiplegia) or partial weakness (hemiparesis)
✓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

•I69.85x: Hemiplegia/hemiparesis following other cerebrovascular disease; use when the specific type of cerebrovascular disease is documented
•I69.94x: Monoplegia of lower limb following unspecified cerebrovascular disease; use when only one limb is paralyzed, not the entire side
•I69.93x: Monoplegia of upper limb following unspecified cerebrovascular disease; use when only one arm is paralyzed, not the entire side
•G81.x: Hemiplegia unspecified as to cause; use when the hemiplegia is not documented as a sequela of cerebrovascular disease
•I63.x: Cerebral infarction (acute stroke); use for the initial acute event, not for long-term sequelae