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ICD-10 Guide
ICD-10 CodesI63.131

I63.131

Billable

Cerebral infarction due to embolism of right carotid artery

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

Code Description

ICD-10 I63.131 is a billable code used to indicate a diagnosis of cerebral infarction due to embolism of right carotid artery.

Key Diagnostic Point:

Cerebral infarction due to embolism of the right carotid artery is a serious condition characterized by the obstruction of blood flow to the brain, resulting in tissue death (infarction) due to an embolus originating from the right carotid artery. Clinically, patients may present with sudden onset of neurological deficits, including weakness or paralysis on one side of the body, speech difficulties, and visual disturbances. The right carotid artery supplies blood to the right side of the brain, and an embolism can arise from various sources, including cardiac arrhythmias, atherosclerotic plaques, or other vascular conditions. Disease progression can lead to significant morbidity, including long-term disability or death if not promptly treated. Diagnostic considerations include imaging studies such as CT or MRI to confirm the presence of an infarct and to identify the source of the embolism. Additional tests may include echocardiography or vascular imaging to assess the carotid arteries and cardiac function.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical assessment to confirm diagnosis.
  • Treatment complexity: May involve acute management with thrombolytics or surgical interventions.
  • Documentation requirements: Detailed clinical notes and imaging results are essential.
  • Coding specificity: Requires precise coding to differentiate from other types of strokes.

Audit Risk Factors

  • Common coding errors: Misidentification of the side of the embolism.
  • Documentation gaps: Incomplete clinical notes regarding the patient's presentation.
  • Billing challenges: Potential denials if documentation does not support the severity 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 significantly impacts population health, contributing to high rates of morbidity and mortality associated with stroke. Effective management and timely intervention can improve outcomes and reduce healthcare utilization. Quality measures focus on rapid diagnosis and treatment, which are critical in minimizing long-term disability. Epidemiologically, this condition is prevalent in populations with risk factors such as hypertension, diabetes, and cardiovascular disease.

ICD-9 vs ICD-10

Cerebral infarction due to embolism significantly impacts population health, contributing to high rates of morbidity and mortality associated with stroke. Effective management and timely intervention can improve outcomes and reduce healthcare utilization. Quality measures focus on rapid diagnosis and treatment, which are critical in minimizing long-term disability. Epidemiologically, this condition is prevalent in populations with risk factors such as hypertension, diabetes, and cardiovascular disease.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the condition and the necessity for acute interventions. Common denials may arise from insufficient documentation of the embolic source or clinical presentation. Best practices include ensuring that all imaging and clinical assessments are thoroughly documented and that the coding accurately reflects the patient's condition to avoid billing challenges.

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 I63.131?

I63.131 specifically covers cerebral infarction due to embolism from the right carotid artery, which may include conditions such as embolic strokes resulting from atrial fibrillation or carotid artery disease.

When should I63.131 be used instead of related codes?

I63.131 should be used when the cerebral infarction is confirmed to be due to an embolism from the right carotid artery, as opposed to other causes such as thrombosis or embolism from the left carotid artery (I63.132).

What documentation supports I63.131?

Documentation should include clinical findings, imaging results confirming the infarction, and evidence of embolic source, such as echocardiogram results or carotid imaging.