I69.359 Hemiplegia and hemiparesis following cerebral infarction affecting unspecified side

ICD-10-CM I69.359: Hemiplegia and hemiparesis following cerebral infarction affecting unspecified side

ICD-10-CM code I69.359 designates hemiplegia and hemiparesis following a cerebral infarction when the affected side is unspecified. Hemiplegia involves total paralysis on one side of the body, while hemiparesis involves partial weakness. This code is assigned when the medical record lacks documentation identifying the affected side. 1 5 6

Plain-language overview

Hemiplegia denotes total paralysis of the arm, leg, and trunk on one side of the body, while hemiparesis denotes muscle weakness or partial paralysis on one side of the body. 1

Hemiparesis and hemiplegia are not diseases themselves, but rather represent nonspecific responses of the central nervous system to a range of insults. 1

What this code represents

The ICD-10-CM code I69.359 represents hemiplegia and hemiparesis following cerebral infarction affecting an unspecified side. 5

Code I69.359 belongs to the I69.35 category for hemiplegia and hemiparesis following cerebral infarction, which includes distinct codes for right dominant, left dominant, right non-dominant, and left non-dominant sides. 6

Documentation considerations

In coding laterality for conditions specifying hemiplegia or hemiparesis, if the affected side is not identified in the medical record, the coder assigns the code for the unspecified side. 6

Medical record documentation for these conditions identifies whether the dominant or non-dominant side is affected to support accurate code selection. 6

Clinical context

In adults, a cerebrovascular accident or stroke is the most common cause of hemiparesis, and large unilateral infarcts of the corticospinal tract can result in contralateral motor hemiparesis or hemiplegia. 1 2

What the sources add

While the National Cancer Institute EVS source establishes the official ICD-10-CM label for I69.359, the AHIMA source provides the operational coding rule to apply this code when laterality is absent from the medical record. 5 6

Coverage and utilization context

The Centers for Medicare and Medicaid Services references the broader I69.35 category in billing and coding articles for non-invasive cerebrovascular arterial studies and botulinum toxins, listing laterality-specific codes like I69.352. 3 4

Sources

1. Acute Hemiplegia in Children: A Prospective Study of Etiology, Clinical Presentation, and Outcome from Western India — pmc.ncbi.nlm.nih.gov; accessed 2026-07-25.
2. Bookshelf — ncbi.nlm.nih.gov; accessed 2026-07-25.
3. Article - Billing and Coding: Non-Invasive Cerebrovascular Arterial Studies (A52992) — cms.gov; accessed 2026-07-25.
4. Article - Billing and Coding: Botulinum Toxins (A58423) — cms.gov; accessed 2026-07-25.
5. EVS Explore — evsexplore.semantics.cancer.gov; accessed 2026-07-25.
6. FY 2013 ICD-10-CM and ICD-10-PCS Updates — journal.ahima.org; accessed 2026-07-25.