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ICD-10 Guide
ICD-10 CodesI63.20

I63.20

Billable

Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries

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

Code Description

ICD-10 I63.20 is a billable code used to indicate a diagnosis of cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries.

Key Diagnostic Point:

Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries refers to a condition where there is a blockage or narrowing of the arteries supplying blood to the brain, leading to a reduction in blood flow and subsequent brain tissue death. The clinical presentation may include sudden onset of neurological deficits such as weakness, numbness, difficulty speaking, or loss of coordination. The anatomy involved primarily includes the carotid arteries, which branch into the internal and external carotid arteries, supplying blood to the brain. Disease progression can vary; some patients may experience transient ischemic attacks (TIAs) before a full-blown stroke occurs. Diagnostic considerations include imaging studies such as CT or MRI scans to visualize the brain and identify areas of infarction, as well as Doppler ultrasound to assess blood flow in the carotid arteries. Risk factors include hypertension, diabetes, hyperlipidemia, and smoking, which can contribute to the occlusion or stenosis of the arteries.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misidentifying the type of stroke or occlusion.
  • Documentation gaps may arise if the clinical notes do not clearly specify the type of occlusion or stenosis.
  • Billing challenges can occur if the documentation does not support the diagnosis or if there are inconsistencies in the medical record.

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Cerebral infarctions significantly impact population health, contributing to morbidity and mortality rates associated with stroke. Quality measures focus on timely diagnosis and treatment to minimize long-term disability. Healthcare utilization patterns show increased emergency department visits and hospital admissions for stroke-related conditions. Epidemiologically, the prevalence of risk factors such as hypertension and diabetes correlates with higher rates of cerebral infarction, highlighting the need for preventive measures in at-risk populations.

ICD-9 vs ICD-10

Cerebral infarctions significantly impact population health, contributing to morbidity and mortality rates associated with stroke. Quality measures focus on timely diagnosis and treatment to minimize long-term disability. Healthcare utilization patterns show increased emergency department visits and hospital admissions for stroke-related conditions. Epidemiologically, the prevalence of risk factors such as hypertension and diabetes correlates with higher rates of cerebral infarction, highlighting the need for preventive measures in at-risk populations.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity is clearly established in the documentation. Common denials may occur if the documentation does not adequately support the diagnosis or if there are discrepancies between the diagnosis and the procedures billed. Best practices include maintaining clear and consistent clinical notes, ensuring that all relevant tests and evaluations are documented, and using the most specific codes available to avoid potential audits.

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 I63.20?

I63.20 covers cerebral infarctions resulting from unspecified occlusion or stenosis of precerebral arteries, which may include conditions like transient ischemic attacks (TIAs) and full strokes without specific identification of the artery involved.

When should I63.20 be used instead of related codes?

I63.20 should be used when the occlusion or stenosis of the precerebral arteries is not specified. If the specific artery affected is known, related codes such as I63.21 or I63.22 should be utilized for more accurate coding.

What documentation supports I63.20?

Documentation should include clinical findings, imaging results, and any relevant history of vascular disease. Clear notes on the patient's symptoms and the physician's assessment are essential to support the use of this code.