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Hemiplegia

The scenario is that both of these codes were documented in the past on a patient.

438.9 Unspecified late effects of CVA   AND  342.11 Spastic hemiplegia affecting dominant side

The physician was queried on which code was appropriate. The documentation returned listing both codes.  If we look in the ICD-9 book, we will see the following, please notice the NOTE and EXCLUDES boxes:



The ICD-9 guidelines state the 342.11 excludes 438.20 - 438.22 (they can't be used together).

On a future appointment, query the physician for clarification on the patient's paralysis.





This is regarding hierarchical condition categories or HCC codes.

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Location: Poway, CA, USA

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