Neurology & Pain Management Coding Alert
Reader Question:
5th Digit for Hemiplegia Refers to Body
Published on Fri Jun 18, 2004
Question: When I code for a late effect CVA, hemiplegia (438.2x), does the fifth-digit designation (dominant, nondominant) refer to the dominant hemisphere of the brain or the dominant side of the body? Arkansas Subscriber Answer: Hemiplegia describes paralysis affecting one side of the body. Therefore, when selecting a fifth digit for 438.2x, you should code according to the affected side of the body (not the brain). For example, a cerebrovascular accident (CVA) victim has hemiplegia on the left side of the body, but the patient is right-handed. In this case, assign 438.22 (Hemiplegia affecting nondominant side).
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