Facebook tracking pixelHemiparesis - AI-Powered ICD-10 Documentation
G81.90
ICD-10-CM
Hemiparesis

Understanding hemiparesis diagnosis, treatment, and prognosis? Find information on hemiparesis symptoms, causes (including stroke and cerebral palsy), and associated ICD-10 codes. Learn about clinical documentation requirements for hemiparesis, including muscle weakness, motor function assessment, and rehabilitation therapies. Explore resources for healthcare professionals, including standardized medical coding guidelines and best practices for accurate hemiparesis documentation.

Also known as

Unilateral weakness
Partial paralysis

Diagnosis Snapshot

Key Facts
  • Definition : Weakness on one side of the body.
  • Clinical Signs : Facial droop, arm or leg weakness, difficulty with coordination.
  • Common Settings : Stroke, brain injury, cerebral palsy, multiple sclerosis.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC G81.90 Coding
G81-G83

Hemiplegia and hemiparesis

Weakness or paralysis on one side of the body.

I60-I69

Cerebrovascular diseases

Conditions affecting blood vessels in the brain, a common cause of hemiparesis.

G00-G99

Diseases of the nervous system

Encompasses various neurological disorders, including hemiparesis.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the hemiparesis dominant side?

  • Yes

    Is it due to a CVA?

  • No

    Is it nondominant side?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Weakness on one side of the body.
Paralysis on one side of the body.
Generalized muscle weakness.

Documentation Best Practices

Documentation Checklist
  • Hemiparesis laterality (left or right)
  • Specific affected body part(s)
  • Muscle strength assessment (e.g., MRC scale)
  • Functional impact of hemiparesis
  • Underlying etiology/cause of hemiparesis

Coding and Audit Risks

Common Risks
  • Laterality Coding

    Incomplete documentation of affected side (right vs. left) leading to inaccurate coding and reimbursement.

  • Dominant Side Impact

    Failure to document dominant vs. non-dominant side impact can affect severity coding and functional assessment.

  • Underlying Cause Code

    Missing or inaccurate coding of the underlying cause of hemiparesis (e.g., stroke, trauma) impacts data integrity.

Mitigation Tips

Best Practices
  • Document hemiparesis laterality (left/right) for accurate ICD-10 coding.
  • Specify hemiparesis onset (acute/chronic) for proper medical billing compliance.
  • Assess muscle strength (MRC scale) for precise clinical documentation improvement.
  • Link hemiparesis to underlying cause (e.g., stroke) for improved CDI and HCC coding.
  • Detail functional limitations for optimal patient care and accurate coding.

Clinical Decision Support

Checklist
  • Unilateral weakness: Assess arm and leg strength bilaterally
  • Rule out stroke: Order urgent head CT/MRI if acute onset
  • Check for other causes: Consider spinal cord injury, nerve damage
  • Document onset, severity: Precisely describe weakness distribution
  • ICD-10 code verification: Ensure proper coding (e.g., H91.1)

Reimbursement and Quality Metrics

Impact Summary
  • Hemiparesis reimbursement hinges on accurate ICD-10 coding (G81.-, G04.1, I69.3) linked to specific laterality and etiology for optimal payment.
  • Coding quality impacts hemiparesis case mix index (CMI), affecting DRG assignment and hospital reimbursement.
  • Timely and specific documentation of hemiparesis severity influences payment and quality reporting metrics like functional independence.
  • Accurate hemiparesis coding supports appropriate resource utilization, impacting hospital efficiency and cost reporting.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code dominant/non-dominant side
  • Specify affected body part
  • Document functional impact
  • Consider laterality codes
  • Review G81/G82/G83

Documentation Templates

Patient presents with hemiparesis, characterized by unilateral weakness affecting one side of the body.  Assessment reveals right left hemiparesis impacting the right left upper and lower extremities.  Onset of hemiparesis symptoms occurred on [Date of Onset], with the patient describing [Onset Characteristics - e.g., gradual onset, sudden onset].  The patient reports [Symptoms - e.g., difficulty with ambulation, decreased grip strength, impaired fine motor skills].  Neurological examination demonstrates [Objective Findings - e.g., reduced muscle power graded [Strength Grade] on the Medical Research Council scale, hyperreflexia, positive Babinski sign].  Differential diagnosis includes stroke, cerebrovascular accident, transient ischemic attack, brain tumor, multiple sclerosis, and traumatic brain injury.  Diagnostic workup including [Diagnostic Tests Performed - e.g., MRI brain, CT scan head, electromyography, nerve conduction studies] is underway to determine the underlying etiology of the hemiparesis.  Current treatment plan includes [Treatment Plan - e.g., physical therapy, occupational therapy, referral to neurology, medication management for spasticity].  Patient education provided on hemiparesis management, stroke rehabilitation, fall prevention strategies, and adaptive equipment.  Follow-up scheduled for [Date of Follow-Up] to reassess functional status and adjust treatment plan as needed.  ICD-10 code [ICD-10 Code - e.g., G81.9, G83.9] assigned.  CPT codes for evaluation and management, diagnostic testing, and therapeutic procedures will be documented separately.  Prognosis for recovery is dependent on the underlying cause and the patient's response to treatment.