I69.159 — Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting unspecified side
Is I69.159 billable?
Yes, but I69.159 will trip a Medicare edit. I69.159 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, CMS lists I69.159 under Medicare Code Editor edit 20, “Unspecified code” — meaning a code specifying laterality (right, left or bilateral) exists in the same family. On an inpatient claim this triggers the edit, because CMS holds that there are very limited circumstances in which laterality cannot be documented.
More specific alternatives
- I69.151Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right dominant side
- I69.152Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left dominant side
- I69.153Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right non-dominant side
- I69.154Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left non-dominant side
I69.159 at a glance
| Code | I69.159 |
|---|---|
| Description | Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting unspecified side |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to I69.159?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name I69.159 directly.
A code specifying laterality (right, left or bilateral) exists in the same family. CMS holds that there are very limited circumstances in which laterality cannot be documented.
Which MS-DRGs does I69.159 group to?
I69.159 sits in MDC 01 and helps define the logic of 2 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 056Degenerative Nervous System Disorders with MCCmedical
- 057Degenerative Nervous System Disorders without MCCmedical
As a secondary diagnosis, I69.159 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is I69.159 listed in the Alphabetic Index?
The Alphabetic Index lists these routes under I69.15, the nearest indexed parent of I69.159. Use them to find the family, then select the specific code.
- Hemiplegia › following › cerebrovascular disease › intracerebral hemorrhage
- Sequelae › hemorrhage › intracerebral › hemiplegia (of)
Excludes1 — never code together — inherited from I60-I69
The conditions below can never be reported together with I69.159 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
- traumatic intracranial hemorrhage (S06.-)
Excludes1 — never code together — inherited from I69
The conditions below can never be reported together with I69.159 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Use additional code — inherited from I60-I69
Report an additional code alongside I69.159 to fully describe the condition. I69.159 is sequenced first.
Excludes2 — not included here — inherited from Chapter 9
The conditions below are not part of I69.159, but a patient may have both at the same time. When documentation supports it, I69.159 and the excluded code may both be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
- systemic connective tissue disorders (M30-M36)
- transient cerebral ischemic attacks and related syndromes (G45.-)
How long has I69.159 existed?
I69.159 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
What other codes are in the I69.15 family? (4)
- I69.151Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right dominant side
- I69.152Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left dominant side
- I69.153Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right non-dominant side
- I69.154Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left non-dominant side