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ICD-10 Guide
ICD-10 CodesI63.011

I63.011

Billable

Cerebral infarction due to thrombosis of right vertebral artery

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

Code Description

ICD-10 I63.011 is a billable code used to indicate a diagnosis of cerebral infarction due to thrombosis of right vertebral artery.

Key Diagnostic Point:

Cerebral infarction due to thrombosis of the right vertebral artery is a type of ischemic stroke that occurs when a blood clot obstructs blood flow in the right vertebral artery, leading to a reduction in oxygen supply to the brain tissue supplied by this artery. Clinically, patients may present with sudden onset of neurological deficits, which can include weakness or numbness on one side of the body, difficulty speaking, or loss of coordination. The vertebral arteries are critical in supplying blood to the posterior circulation of the brain, including the brainstem and cerebellum. Disease progression can vary; some patients may experience transient ischemic attacks (TIAs) prior to a full-blown stroke, while others may have a sudden and severe presentation. Diagnostic considerations include neuroimaging studies such as CT or MRI to confirm the presence of an infarct and to rule out hemorrhagic stroke. Additionally, vascular imaging may be performed to assess for thrombosis or stenosis in the vertebral artery.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical assessment to confirm diagnosis.
  • Treatment complexity: May involve anticoagulation therapy, rehabilitation, and monitoring.
  • Documentation requirements: Detailed clinical notes and imaging reports are necessary.
  • Coding specificity: Requires accurate identification of the affected artery and type of infarction.

Audit Risk Factors

  • Common coding errors: Misidentification of the affected artery or type of stroke.
  • Documentation gaps: Incomplete clinical notes regarding patient presentation and imaging results.
  • Billing challenges: Potential denials due to insufficient documentation or incorrect coding.

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Cerebral infarction due to thrombosis of the right vertebral artery has significant clinical implications, affecting patient outcomes and healthcare costs. It is a leading cause of morbidity and mortality, impacting population health significantly. Quality measures often focus on timely diagnosis and treatment of strokes, which can improve healthcare utilization patterns and reduce long-term disability. Epidemiologically, the incidence of strokes related to vertebral artery thrombosis highlights the need for awareness and prevention strategies in at-risk populations.

ICD-9 vs ICD-10

Cerebral infarction due to thrombosis of the right vertebral artery has significant clinical implications, affecting patient outcomes and healthcare costs. It is a leading cause of morbidity and mortality, impacting population health significantly. Quality measures often focus on timely diagnosis and treatment of strokes, which can improve healthcare utilization patterns and reduce long-term disability. Epidemiologically, the incidence of strokes related to vertebral artery thrombosis highlights the need for awareness and prevention strategies in at-risk populations.

Reimbursement & Billing Impact

Reimbursement considerations include the need for thorough clinical notes that justify the diagnosis and any imaging studies performed. Common denials may arise from insufficient documentation or failure to provide evidence of medical necessity. Best practices include ensuring that all relevant clinical findings are documented and that the coding accurately reflects the patient's diagnosis and treatment plan.

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 I63.011?

I63.011 specifically covers cerebral infarction resulting from thrombosis of the right vertebral artery. This includes acute ischemic strokes and may also encompass transient ischemic attacks (TIAs) that are related to the same vascular event.

When should I63.011 be used instead of related codes?

I63.011 should be used when the clinical documentation indicates a cerebral infarction specifically due to thrombosis of the right vertebral artery. It is important to differentiate from other codes such as I63.012, which pertains to the left vertebral artery.

What documentation supports I63.011?

Documentation should include a detailed clinical history, neurological examination findings, imaging results (CT or MRI), and any vascular studies that confirm thrombosis of the right vertebral artery.