ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 I69.062

Billable / Specific HCC v28: 104

Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting left dominant side

I69
Block
0
Synonyms
411
LCDs
9
Payer Policies
0
Linked CPTs

About ICD-10-CM I69.062

ICD-10-CM code I69.062 represents Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting left dominant side. This is a billable/specific code in the Circulatory System chapter (block I69). The 2026 edition of ICD-10-CM I69.062 became effective on October 1, 2025.

Coding Tips for I69.062

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

I69.062 is a CMS-HCC v28 risk-adjustment code (category 104). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 104
ESRD-HCC
Category 104
RxHCC (Part D)
Category 104

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Medicare LCD Coverage for I69.062

Local Coverage Determinations (LCDs) from CMS MACs that list I69.062 as a covered diagnosis.

411 LCDs

Showing top 10 of 411 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29131 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29260 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29580 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97036 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29445 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97542 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97110 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 97533 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29130 →
CMS LCD: Billing and Coding: Outpatient Physical Therapy
Article ID: 53065, Effective: 2026-01-01 00:00:00, 22208 covered, 0 non-covered
CPT 29405 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I69.062.

9 policies

5 Medicare

Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065
Billing and Coding: Nerve Conduction Studies and Electromyography
Policy ID: ART-54095
Billing and Coding: Nerve Conduction Studies and Electromyography
Policy ID: ART-57123

CPT Codes Commonly Billed with I69.062

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for I69.062

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert I69.062 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
I69.062 43851 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To I69.062

Other codes in section I60-I69 (Cerebrovascular diseases).

I60 Nontraumatic subarachnoid hemorrhage (non-billable) I60.0 Nontraumatic subarachnoid hemorrhage from carotid siphon and bifurcation (non-billable) I60.00 Nontraumatic subarachnoid hemorrhage from unspecified carotid siphon and bifurcation I60.01 Nontraumatic subarachnoid hemorrhage from right carotid siphon and bifurcation I60.02 Nontraumatic subarachnoid hemorrhage from left carotid siphon and bifurcation I60.1 Nontraumatic subarachnoid hemorrhage from middle cerebral artery (non-billable) I60.10 Nontraumatic subarachnoid hemorrhage from unspecified middle cerebral artery I60.11 Nontraumatic subarachnoid hemorrhage from right middle cerebral artery I60.12 Nontraumatic subarachnoid hemorrhage from left middle cerebral artery I60.2 Nontraumatic subarachnoid hemorrhage from anterior communicating artery I60.3 Nontraumatic subarachnoid hemorrhage from posterior communicating artery (non-billable) I60.30 Nontraumatic subarachnoid hemorrhage from unspecified posterior communicating artery I60.31 Nontraumatic subarachnoid hemorrhage from right posterior communicating artery I60.32 Nontraumatic subarachnoid hemorrhage from left posterior communicating artery I60.4 Nontraumatic subarachnoid hemorrhage from basilar artery I60.5 Nontraumatic subarachnoid hemorrhage from vertebral artery (non-billable) I60.50 Nontraumatic subarachnoid hemorrhage from unspecified vertebral artery I60.51 Nontraumatic subarachnoid hemorrhage from right vertebral artery I60.52 Nontraumatic subarachnoid hemorrhage from left vertebral artery I60.6 Nontraumatic subarachnoid hemorrhage from other intracranial arteries

ICD-10 I69.062, Billing FAQ

Is ICD-10 code I69.062 billable? +

Yes, I69.062 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does I69.062 affect Medicare Advantage HCC risk adjustment? +

Yes. I69.062 maps to CMS-HCC v28 category 104. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What ICD-9 codes does I69.062 map to? +

Per CMS GEMs, I69.062 maps to ICD-9 codes: 43851. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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