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ICD-10 Guide
ICD-10 CodesI63.02

I63.02

Billable

Cerebral infarction due to thrombosis of basilar artery

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

Code Description

ICD-10 I63.02 is a billable code used to indicate a diagnosis of cerebral infarction due to thrombosis of basilar artery.

Key Diagnostic Point:

Cerebral infarction due to thrombosis of the basilar artery is a critical condition characterized by the obstruction of blood flow to the brain, specifically affecting the basilar artery, which supplies blood to the brainstem and cerebellum. Clinically, patients may present with sudden onset of neurological deficits, including dizziness, visual disturbances, ataxia, and altered consciousness, depending on the area of the brain affected. The basilar artery is formed by the union of the two vertebral arteries and is crucial for brainstem function. Disease progression can lead to significant morbidity, including long-term disability or death if not promptly treated. Diagnostic considerations include neuroimaging techniques such as CT or MRI to confirm the presence of an infarct and to rule out hemorrhagic stroke. Risk factors for thrombosis include atherosclerosis, hypertension, diabetes, and hyperlipidemia, which contribute to the narrowing of the arteries and subsequent thrombus formation. Early recognition and intervention are vital to improve outcomes and minimize complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical evaluation to differentiate from other stroke types.
  • Treatment complexity: May involve acute management with thrombolytics or antiplatelet therapy, and long-term rehabilitation.
  • Documentation requirements: Detailed clinical notes and imaging reports are essential for accurate coding.
  • Coding specificity: Requires precise coding to differentiate from other types of cerebral infarctions.

Audit Risk Factors

  • Common coding errors: Misclassification of stroke type or failure to document risk factors.
  • Documentation gaps: Incomplete clinical notes or lack of imaging results can lead to coding inaccuracies.
  • Billing challenges: Potential denials if documentation does not support the severity or type of stroke.

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 basilar artery has significant clinical implications, as it can lead to severe disability and increased healthcare utilization. Understanding the epidemiology of this condition is crucial, as it affects a substantial portion of the population, particularly older adults with comorbidities. Quality measures focusing on timely diagnosis and treatment can improve patient outcomes and reduce long-term healthcare costs.

ICD-9 vs ICD-10

Cerebral infarction due to thrombosis of the basilar artery has significant clinical implications, as it can lead to severe disability and increased healthcare utilization. Understanding the epidemiology of this condition is crucial, as it affects a substantial portion of the population, particularly older adults with comorbidities. Quality measures focusing on timely diagnosis and treatment can improve patient outcomes and reduce long-term healthcare costs.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the stroke and the complexity of care provided. Common denials may arise from insufficient documentation or failure to demonstrate the acute nature of the condition. Best practices include ensuring that all clinical notes are complete and that imaging studies are clearly linked to the diagnosis. Coders should also be aware of payer-specific guidelines for stroke management 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 I63.02?

I63.02 specifically covers cerebral infarction resulting from thrombosis of the basilar artery, which may lead to various neurological deficits. It is essential to differentiate this from other types of strokes, such as those caused by embolism or hemorrhage.

When should I63.02 be used instead of related codes?

I63.02 should be used when the cerebral infarction is confirmed to be due to thrombosis of the basilar artery, as opposed to embolic strokes or infarctions in other cerebral arteries. Accurate diagnosis through imaging is crucial for appropriate code selection.

What documentation supports I63.02?

Documentation must include clinical findings, imaging results confirming the infarction, and details of the patient's medical history, including risk factors for stroke. Comprehensive notes from neurologists or emergency physicians are vital.