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ICD-10 Guide
ICD-10 CodesI63.433

I63.433

Billable

Cerebral infarction due to embolism of bilateral posterior cerebral arteries

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

Code Description

ICD-10 I63.433 is a billable code used to indicate a diagnosis of cerebral infarction due to embolism of bilateral posterior cerebral arteries.

Key Diagnostic Point:

Cerebral infarction due to embolism of bilateral posterior cerebral arteries is characterized by the obstruction of blood flow to the posterior cerebral arteries, which supply blood to the occipital lobe and parts of the temporal lobe. Clinically, patients may present with symptoms such as visual disturbances, hemianopsia, and cognitive deficits, depending on the extent of the infarction and the areas affected. The anatomy involved includes the posterior cerebral arteries, which branch from the basilar artery and are crucial for supplying oxygenated blood to vital brain structures. Disease progression can vary; some patients may experience rapid onset of symptoms, while others may have a more gradual decline. Diagnostic considerations include neuroimaging techniques such as CT or MRI scans to confirm the presence of an infarct and to rule out other conditions. Additionally, a thorough assessment of risk factors, including atrial fibrillation and other embolic sources, is essential for effective management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation to confirm diagnosis.
  • Treatment complexity: Management may involve anticoagulation therapy and rehabilitation.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis.
  • Coding specificity: Requires precise coding to differentiate from other types of cerebral infarctions.

Audit Risk Factors

  • Common coding errors: Misidentification of the affected arteries or incorrect laterality.
  • Documentation gaps: Insufficient clinical details regarding the embolic source or patient history.
  • Billing challenges: Potential denials due to lack of supporting documentation for 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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of I63.433 lies in its association with significant morbidity and potential mortality. Understanding the epidemiology of bilateral posterior cerebral artery infarctions can inform population health strategies and improve quality measures. Healthcare utilization patterns may reflect increased demand for neurological rehabilitation services and long-term follow-up care for affected patients.

ICD-9 vs ICD-10

The clinical significance of I63.433 lies in its association with significant morbidity and potential mortality. Understanding the epidemiology of bilateral posterior cerebral artery infarctions can inform population health strategies and improve quality measures. Healthcare utilization patterns may reflect increased demand for neurological rehabilitation services and long-term follow-up care for affected patients.

Reimbursement & Billing Impact

Reimbursement considerations include the need for prior authorization for imaging studies and potential therapy. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include ensuring that all clinical notes are thorough and that imaging results are clearly linked to the diagnosis.

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 I63.433?

I63.433 specifically covers cerebral infarctions resulting from embolic events affecting both posterior cerebral arteries. This includes conditions such as embolic strokes secondary to cardiac arrhythmias or other embolic sources.

When should I63.433 be used instead of related codes?

I63.433 should be used when there is clear evidence of bilateral posterior cerebral artery involvement due to embolism. If the infarction is unilateral or due to other causes, different codes should be selected.

What documentation supports I63.433?

Documentation should include imaging results confirming bilateral infarction, clinical notes detailing the patient's symptoms, and any relevant history of embolic sources such as atrial fibrillation.