Both arm weakness in CVA

We have a patient that presented with syncopal episode at home with weakness both arms, could not lift arm or leg off cart, could not speak/slurred speech, however awake and aware of surroundings.  He was administered tPA and his symptoms completely resolved.  He was diagnosed with an acute ischemic stroke. Normally we would code hemiplegia since the weakness was related to stroke, but there is a question that since both arms were affected, would hemiplegia be appropriate.  


  • G83.0 Diplegia of upper limbs

    Includes: "paralysis of both upper limbs"

    Interestingly, since the patient also had unilateral weakness on one side you also have the G81 code for hemiplegia.

    Looking at the instructional notes I see this under G83
    "Includes paralysis (complete) (incomplete), EXCEPT as in G80-82...which seems to indicate coding a G83 with a G81 is acceptable.  

    There are no excludes 1 notes that interact between G81 and G83 that I can see using my book.

  • See also AHA CC 1Q 2017 pg 47.
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