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ICD-10 Guide
ICD-10 CodesI63.019

I63.019

Billable

Cerebral infarction due to thrombosis of unspecified vertebral artery

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

Code Description

ICD-10 I63.019 is a billable code used to indicate a diagnosis of cerebral infarction due to thrombosis of unspecified vertebral artery.

Key Diagnostic Point:

Cerebral infarction due to thrombosis of the unspecified vertebral artery is a condition characterized by the obstruction of blood flow to the brain caused by a thrombus (blood clot) that forms in one of the vertebral arteries. These arteries are crucial as they supply blood to the posterior part of the brain, including the cerebellum and brainstem. Clinical presentation may include sudden onset of neurological deficits such as weakness, numbness, difficulty speaking, or loss of coordination. The disease progression can lead to significant morbidity, including long-term disability or death, if not promptly diagnosed and treated. Diagnostic considerations involve neuroimaging techniques such as CT or MRI scans to visualize the infarction and assess the extent of brain damage. Additionally, vascular imaging may be utilized to identify the presence of thrombosis in the vertebral artery. Early intervention is critical to restore blood flow and minimize brain damage, often necessitating a multidisciplinary approach for optimal management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical evaluation to confirm diagnosis.
  • Treatment complexity: May involve anticoagulation therapy, rehabilitation, and monitoring.
  • Documentation requirements: Detailed clinical notes and imaging results are essential.
  • Coding specificity: Must differentiate from other types of cerebral infarctions.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of cerebral infarction.
  • Documentation gaps: Incomplete clinical notes regarding the patient's history and imaging results.
  • Billing challenges: Potential denials if documentation does not 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

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

The clinical significance of I63.019 lies in its potential to lead to severe neurological deficits and increased healthcare utilization due to the need for emergency interventions and rehabilitation services. The population health impact is notable, as strokes are a leading cause of disability and mortality worldwide. Quality measures may include timely diagnosis and treatment, which are critical for improving patient outcomes and reducing long-term complications associated with cerebral infarctions.

ICD-9 vs ICD-10

The clinical significance of I63.019 lies in its potential to lead to severe neurological deficits and increased healthcare utilization due to the need for emergency interventions and rehabilitation services. The population health impact is notable, as strokes are a leading cause of disability and mortality worldwide. Quality measures may include timely diagnosis and treatment, which are critical for improving patient outcomes and reducing long-term complications associated with cerebral infarctions.

Reimbursement & Billing Impact

Reimbursement may depend on the completeness of clinical notes, imaging studies, and the rationale for the chosen treatment plan. Common denials can occur if the documentation does not clearly support the diagnosis of cerebral infarction due to thrombosis. Best practices include ensuring that all relevant clinical findings and imaging results are included in the patient's medical record to facilitate accurate billing.

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 I63.019?

I63.019 covers cerebral infarctions specifically due to thrombosis of the unspecified vertebral artery. This includes cases where the exact location of the thrombus is not specified but results in ischemic stroke symptoms.

When should I63.019 be used instead of related codes?

I63.019 should be used when the clinical scenario indicates a cerebral infarction due to thrombosis in the vertebral artery without specifying which artery is affected. If a specific artery is identified, the corresponding code should be used.

What documentation supports I63.019?

Documentation should include a detailed history of the patient's symptoms, results from neuroimaging studies confirming the infarction, and any relevant laboratory findings that support the diagnosis of thrombosis.