Flaccid hemiplegia affecting left dominant side
ICD-10 G81.02 is a billable code used to indicate a diagnosis of flaccid hemiplegia affecting left dominant side.
Flaccid hemiplegia is a condition characterized by weakness or paralysis on one side of the body, specifically affecting the left side in individuals who are left-dominant. This condition often arises from neurological damage, such as that caused by a stroke, traumatic brain injury, or cerebral palsy. In flaccid hemiplegia, the affected muscles exhibit reduced tone and strength, leading to significant mobility impairments. Patients may experience difficulties with daily activities, such as walking, grasping objects, or maintaining balance. The condition can also lead to secondary complications, including muscle atrophy, joint contractures, and increased risk of falls. Rehabilitation strategies often involve physical therapy, occupational therapy, and assistive devices to enhance mobility and independence. Understanding the underlying cause of the hemiplegia is crucial for effective management and coding, as it can influence treatment options and prognosis.
Detailed neurological examination findings, including muscle tone and strength assessments.
Patients presenting with sudden onset of weakness, post-stroke rehabilitation, or chronic conditions like cerebral palsy.
Ensure clear documentation of the neurological assessment and any imaging studies performed.
Therapy progress notes detailing functional mobility assessments and treatment plans.
Rehabilitation sessions focusing on improving strength and mobility in patients with hemiplegia.
Document specific goals and outcomes related to mobility improvements.
Used for rehabilitation of patients with flaccid hemiplegia to improve strength and mobility.
Document specific exercises performed and progress made.
Physical therapists should note the patient's baseline and goals for therapy.
Flaccid hemiplegia is characterized by reduced muscle tone and weakness, while spastic hemiplegia involves increased muscle tone and stiffness. Accurate documentation is essential to differentiate between the two for proper coding.
