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ICD-10 Guide
ICD-10 CodesI63.113

I63.113

Billable

Cerebral infarction due to embolism of bilateral vertebral arteries

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

Code Description

ICD-10 I63.113 is a billable code used to indicate a diagnosis of cerebral infarction due to embolism of bilateral vertebral arteries.

Key Diagnostic Point:

Cerebral infarction due to embolism of bilateral vertebral arteries is a serious condition characterized by the obstruction of blood flow to the brain caused by an embolus originating from the vertebral arteries. These arteries supply blood to the posterior circulation of the brain, including the brainstem and cerebellum. Clinical presentation may include sudden onset of neurological deficits such as weakness, dizziness, balance issues, and visual disturbances. The disease progression can vary; some patients may experience transient ischemic attacks (TIAs) before a full-blown infarction occurs. Diagnostic considerations include imaging studies such as MRI or CT scans to identify the location and extent of the infarction, as well as vascular studies to assess blood flow in the vertebral arteries. Risk factors include atherosclerosis, cardiac arrhythmias, and other cardiovascular diseases that predispose individuals to embolic events. Early recognition and intervention are crucial to minimize long-term neurological deficits.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires advanced imaging and understanding of cerebrovascular anatomy.
  • Treatment complexity: May involve anticoagulation therapy, rehabilitation, and management of underlying conditions.
  • Documentation requirements: Detailed clinical notes and imaging results are essential for accurate coding.
  • Coding specificity: Requires precise identification of the embolic source and affected arteries.

Audit Risk Factors

  • Common coding errors: Misidentification of the affected arteries or embolic source.
  • Documentation gaps: Incomplete clinical notes or lack of imaging results.
  • Billing challenges: Denials due to insufficient documentation or incorrect coding of the condition.

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 embolism of bilateral vertebral arteries significantly impacts clinical outcomes, leading to potential long-term disability and increased healthcare utilization. Understanding the epidemiology of this condition is crucial, as it contributes to stroke prevalence and associated morbidity in the population. Quality measures focus on timely diagnosis and intervention, which can improve patient outcomes and reduce the burden on healthcare systems.

ICD-9 vs ICD-10

Cerebral infarction due to embolism of bilateral vertebral arteries significantly impacts clinical outcomes, leading to potential long-term disability and increased healthcare utilization. Understanding the epidemiology of this condition is crucial, as it contributes to stroke prevalence and associated morbidity in the population. Quality measures focus on timely diagnosis and intervention, which can improve patient outcomes and reduce the burden on healthcare systems.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the case and the need for potential rehabilitation services. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for imaging. Best practices include thorough documentation of all clinical findings and ensuring that the coding accurately reflects the patient's condition 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 I63.113?

I63.113 covers cerebral infarctions specifically due to embolism from bilateral vertebral arteries, which may arise from various conditions such as atherosclerosis, cardiac emboli, or dissection.

When should I63.113 be used instead of related codes?

I63.113 should be used when there is clear evidence of embolic infarction affecting both vertebral arteries, distinguishing it from unilateral cases or other types of strokes.

What documentation supports I63.113?

Documentation should include clinical findings, imaging results confirming bilateral vertebral artery involvement, and any relevant history of embolic events or risk factors.