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Internal Medicine Coding Alert

438 Series Documents the Late Effects of Stroke

Published on Mon Jul 01, 2002

The 438.0-438.9 series (Late effects of cerebro-vascular disease) is used to document late effects from the cerebrovascular conditions described in ICD-9 codes 430-437.

Coders should use:

  • 438.0 (Late effects of cerebrovascular disease; cognitive deficits) for cognitive deficits.

  • 438.1 ( speech and language deficits) with a required fifth digit to specify a speech or language impairment.

  • 438.2 ( hemiplegia/hemiparesis) with a required fifth digit to indicate paralysis affecting one side of the body.

  • 438.3 ( monoplegia of upper limb) with a required fifth digit to indicate the site of paralysis on the upper body, when the late effect is paralysis of one limb or muscle group.

  • 438.4 ( monoplegia of lower limb) with a required fifth digit to indicate the site of paralysis on the lower body, when the late effect is paralysis of one limb or muscle group.

  • 438.5 (... other paralytic syndrome) with a required fifth digit to indicate paralysis of another type. You must also use a second ICD-9 code to identify the type of paralytic syndrome.

  • 438.8 ( other late effects of cerebrovascular disease) with a required fifth digit to indicate other late effects. 438.89 requires an additional code to identify the specific late effect.

  • 438.9 ( unspecified late effects of cerebro-vascular disease) when the late effect is not named.

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