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ICD-10 Guide
ICD-10 CodesI63.03

I63.03

Non-billable

Cerebral infarction due to thrombosis of carotid artery

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

Code Description

ICD-10 I63.03 is a used to indicate a diagnosis of cerebral infarction due to thrombosis of carotid artery.

Key Diagnostic Point:

Cerebral infarction due to thrombosis of the carotid artery is a type of ischemic stroke that occurs when a blood clot forms in the carotid artery, obstructing blood flow to the brain. Clinically, patients may present with sudden onset of neurological deficits, including weakness or numbness on one side of the body, difficulty speaking, or loss of coordination. The carotid arteries, located on either side of the neck, are crucial for supplying blood to the brain. Thrombosis in these arteries can result from atherosclerosis, where plaque builds up and narrows the artery, or from other conditions that promote clot formation. Disease progression can lead to irreversible brain damage if not promptly treated. Diagnostic considerations include imaging studies such as CT or MRI scans to confirm the presence of an infarct and Doppler ultrasound to assess carotid artery patency. Timely intervention is critical to restore blood flow and minimize neurological damage.

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, surgical intervention, or rehabilitation.
  • Documentation requirements: Detailed clinical notes and imaging results are essential.
  • Coding specificity: Requires precise documentation of the cause and location of the infarction.

Audit Risk Factors

  • Common coding errors: Misclassification of stroke type or failure to document the cause.
  • Documentation gaps: Incomplete clinical notes regarding patient history and treatment.
  • 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

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 the carotid artery has significant clinical implications, as it is a leading cause of disability and mortality worldwide. Understanding its epidemiology aids in identifying at-risk populations and implementing preventive measures. Quality measures focus on timely diagnosis and treatment, which can improve patient outcomes and reduce healthcare utilization. Effective management of this condition is crucial for enhancing population health and reducing the burden on healthcare systems.

ICD-9 vs ICD-10

Cerebral infarction due to thrombosis of the carotid artery has significant clinical implications, as it is a leading cause of disability and mortality worldwide. Understanding its epidemiology aids in identifying at-risk populations and implementing preventive measures. Quality measures focus on timely diagnosis and treatment, which can improve patient outcomes and reduce healthcare utilization. Effective management of this condition is crucial for enhancing population health and reducing the burden on healthcare systems.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of demonstrating medical necessity for imaging and treatment interventions. Common denials may arise from insufficient documentation or failure to link the diagnosis to the services provided. Best practices include ensuring that all clinical notes are thorough and that the rationale for procedures is clearly articulated in the medical record.

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 I63.03?

I63.03 specifically covers cerebral infarctions resulting from thrombosis in the carotid artery, which may include conditions like transient ischemic attacks (TIAs) that lead to permanent neurological deficits.

When should I63.03 be used instead of related codes?

I63.03 should be used when the cerebral infarction is directly attributed to thrombosis of the carotid artery, differentiating it from other ischemic strokes that may arise from embolism or other vascular issues.

What documentation supports I63.03?

Documentation should include clinical findings, imaging results confirming the presence of a thrombus in the carotid artery, and a detailed account of the patient's neurological status and treatment plan.