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ICD-10 Guide
ICD-10 CodesI63.013

I63.013

Billable

Cerebral infarction due to thrombosis of bilateral vertebral arteries

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

Code Description

ICD-10 I63.013 is a billable code used to indicate a diagnosis of cerebral infarction due to thrombosis of bilateral vertebral arteries.

Key Diagnostic Point:

Cerebral infarction due to thrombosis of bilateral vertebral arteries is a serious condition characterized by the obstruction of blood flow to the brain caused by a thrombus (blood clot) that forms in the vertebral arteries. These arteries are crucial for supplying blood to the posterior circulation of the brain, which includes the cerebellum and brainstem. Clinical presentation may include sudden onset of neurological deficits such as dizziness, vertigo, ataxia, visual disturbances, and possibly loss of consciousness. The disease progression can lead to significant morbidity, including long-term disability or death, depending on the extent of the infarction and the promptness of treatment. Diagnostic considerations include neuroimaging studies such as CT or MRI to identify the location and extent of the infarction, as well as vascular imaging to assess the status of the vertebral arteries. Risk factors for thrombosis include atherosclerosis, hypertension, and hypercoagulable states, which should be evaluated in affected patients.

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 documentation of symptoms, imaging results, and treatment plans is essential.
  • Coding specificity: Requires precise coding to differentiate from other types of cerebral infarctions.

Audit Risk Factors

  • Common coding errors: Misidentification of the type of infarction or the affected arteries.
  • Documentation gaps: Insufficient detail in clinical notes regarding symptoms and imaging findings.
  • Billing challenges: Potential for denials if documentation does not clearly support the diagnosis.

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

Cardiology

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 bilateral vertebral arteries has significant clinical implications, as it can lead to severe neurological deficits and increased healthcare utilization. Understanding the epidemiology of this condition is crucial, as it affects a notable portion of the population, particularly those with underlying cardiovascular risk factors. Quality measures related to timely diagnosis and treatment can improve outcomes and reduce long-term disability.

ICD-9 vs ICD-10

Cerebral infarction due to thrombosis of bilateral vertebral arteries has significant clinical implications, as it can lead to severe neurological deficits and increased healthcare utilization. Understanding the epidemiology of this condition is crucial, as it affects a notable portion of the population, particularly those with underlying cardiovascular risk factors. Quality measures related to timely diagnosis and treatment can improve outcomes and reduce long-term disability.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that all relevant imaging and treatment procedures are coded accurately. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for imaging studies. Best practices include maintaining thorough clinical notes, ensuring that all risk factors are documented, and using appropriate modifiers when necessary to clarify the nature of the services provided.

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 I63.013?

I63.013 specifically covers cerebral infarction resulting from thrombosis of both vertebral arteries. It is important to differentiate this from other types of cerebral infarctions, such as those due to embolism or hemorrhage.

When should I63.013 be used instead of related codes?

I63.013 should be used when there is clear evidence of bilateral vertebral artery thrombosis leading to cerebral infarction. If the infarction is unilateral or due to other causes, other codes should be considered.

What documentation supports I63.013?

Documentation should include clinical findings, imaging results confirming bilateral vertebral artery thrombosis, and any relevant history of risk factors such as hypertension or previous strokes.