ICD-10 I69.152
Billable / Specific HCC v28: 103 CCHemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left dominant side
About ICD-10-CM I69.152
ICD-10-CM code I69.152 represents Hemiplegia and hemiparesis following nontraumatic intracerebral 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 I69.152 became effective on October 1, 2025.
Coding Tips for I69.152
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
I69.152 is a CMS-HCC v28 risk-adjustment code (category 103). 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.
I69.152 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, CC
codes Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left dominant side. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for I69.152
Local Coverage Determinations (LCDs) from CMS MACs that list I69.152 as a covered diagnosis.
Showing top 10 of 667 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing I69.152.
1 Cigna
5 Medicare
1 NY Medicaid
CPT Codes Commonly Billed with I69.152
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
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 I69.152 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| I69.152 | 43821 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To I69.152
Other codes in section I60-I69 (Cerebrovascular diseases).
ICD-10 I69.152, Billing FAQ
Is ICD-10 code I69.152 billable? +
Yes, I69.152 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does I69.152 affect Medicare Advantage HCC risk adjustment? +
Yes. I69.152 maps to CMS-HCC v28 category 103. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is I69.152 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What ICD-9 codes does I69.152 map to? +
Per CMS GEMs, I69.152 maps to ICD-9 codes: 43821. 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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