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ICD-10 Guide
ICD-10 CodesI63.01

I63.01

Non-billable

Cerebral infarction due to thrombosis of vertebral artery

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 I63.01 is a used to indicate a diagnosis of cerebral infarction due to thrombosis of vertebral artery.

Key Diagnostic Point:

Cerebral infarction due to thrombosis of the vertebral artery is a type of ischemic stroke that occurs when a blood clot obstructs blood flow in the vertebral artery, which supplies blood to the posterior part of the brain. Clinically, patients may present with sudden onset of neurological deficits, including dizziness, vertigo, ataxia, visual disturbances, and unilateral weakness or numbness. The vertebral arteries, branching from the subclavian arteries, run along the cervical spine and merge to form the basilar artery, which is crucial for brainstem and cerebellar perfusion. Disease progression can lead to significant morbidity, including long-term disability or death if not promptly addressed. Diagnostic considerations include neuroimaging techniques such as CT or MRI to confirm the presence of an infarct and to rule out hemorrhagic stroke. Additionally, vascular imaging may be utilized to assess for thrombosis or stenosis in the vertebral artery. Early recognition and intervention are critical in managing this condition to restore blood flow and minimize brain damage.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation to confirm diagnosis.
  • Treatment complexity: May involve anticoagulation therapy, rehabilitation, and management of risk factors.
  • Documentation requirements: Detailed clinical notes and imaging reports are necessary for accurate coding.
  • Coding specificity: Requires precise documentation of the infarction's location and cause.

Audit Risk Factors

  • Common coding errors: Misidentification of the type of stroke or incorrect documentation of the artery involved.
  • Documentation gaps: Lack of detailed clinical notes or imaging results to support the diagnosis.
  • Billing challenges: Potential denials if documentation does not clearly establish the cause and nature of the infarction.

Specialty Focus

Medical Specialties

Neurology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Emergency Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Cerebral infarction due to thrombosis of the vertebral artery has significant clinical implications, contributing to stroke-related morbidity and mortality. It affects a substantial portion of the population, particularly older adults and those with vascular risk factors. Understanding the epidemiology of this condition can inform public health strategies aimed at prevention and management. Quality measures related to timely diagnosis and treatment are crucial in improving patient outcomes and reducing healthcare utilization associated with complications from strokes.

ICD-9 vs ICD-10

Cerebral infarction due to thrombosis of the vertebral artery has significant clinical implications, contributing to stroke-related morbidity and mortality. It affects a substantial portion of the population, particularly older adults and those with vascular risk factors. Understanding the epidemiology of this condition can inform public health strategies aimed at prevention and management. Quality measures related to timely diagnosis and treatment are crucial in improving patient outcomes and reducing healthcare utilization associated with complications from strokes.

Reimbursement & Billing Impact

Reimbursement considerations include the potential for higher payments for more complex cases, but also the risk of denials if documentation is insufficient. Common denials may arise from unclear clinical indications or lack of supporting imaging studies. Adhering to coding best practices, such as using the most specific code available and ensuring all documentation aligns with the diagnosis, can help mitigate these risks.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by I63.01?

I63.01 specifically covers cerebral infarction due to thrombosis of the vertebral artery, which may result from atherosclerosis, embolism, or other vascular conditions leading to occlusion.

When should I63.01 be used instead of related codes?

I63.01 should be used when the cerebral infarction is specifically due to thrombosis of the vertebral artery, as opposed to other types of strokes or occlusions affecting different arteries.

What documentation supports I63.01?

Documentation should include clinical notes detailing the patient's symptoms, results from neuroimaging confirming the infarction, and any vascular studies indicating thrombosis of the vertebral artery.