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ICD-10 Guide
ICD-10 CodesI63.513

I63.513

Billable

Cerebral infarction due to unspecified occlusion or stenosis of bilateral middle cerebral arteries

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

Code Description

ICD-10 I63.513 is a billable code used to indicate a diagnosis of cerebral infarction due to unspecified occlusion or stenosis of bilateral middle cerebral arteries.

Key Diagnostic Point:

Cerebral infarction due to unspecified occlusion or stenosis of bilateral middle cerebral arteries refers to a type of stroke that occurs when blood flow to a part of the brain is interrupted due to blockage or narrowing of the middle cerebral arteries (MCA). The MCA is a critical vessel that supplies blood to large portions of the lateral aspect of the cerebral hemispheres, including areas responsible for motor and sensory functions. Clinical presentation may include sudden onset of weakness, numbness, difficulty speaking, or visual disturbances, depending on the area of the brain affected. Disease progression can lead to significant neurological deficits and complications such as seizures or cognitive impairment. Diagnostic considerations include neuroimaging studies like CT or MRI to confirm the presence of an infarct and to rule out hemorrhagic stroke. Additionally, vascular imaging may be necessary to assess the occlusion or stenosis of the MCA. Early intervention is crucial to minimize brain damage and improve outcomes.

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 intervention.
  • Documentation requirements: Detailed clinical notes and imaging reports are essential.
  • Coding specificity: Requires precise coding to differentiate from other types of strokes.

Audit Risk Factors

  • Common coding errors: Misidentification of the type of stroke or occlusion.
  • Documentation gaps: Incomplete clinical notes or lack of imaging results.
  • Billing challenges: Potential denials if the medical necessity is not clearly documented.

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

Emergency Medicine

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, including those coded as I63.513, have significant clinical implications, contributing to morbidity and mortality rates associated with stroke. The impact on population health is profound, as strokes are a leading cause of disability and can result in long-term healthcare needs. Quality measures related to stroke care, such as timely intervention and rehabilitation services, are critical for improving patient outcomes and reducing healthcare utilization.

ICD-9 vs ICD-10

Cerebral infarctions, including those coded as I63.513, have significant clinical implications, contributing to morbidity and mortality rates associated with stroke. The impact on population health is profound, as strokes are a leading cause of disability and can result in long-term healthcare needs. Quality measures related to stroke care, such as timely intervention and rehabilitation services, are critical for improving patient outcomes and reducing healthcare utilization.

Reimbursement & Billing Impact

reimbursement issues.

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 I63.513?

I63.513 covers cerebral infarctions resulting from unspecified occlusions or stenosis of the bilateral middle cerebral arteries, which may include transient ischemic attacks (TIAs) and full-blown strokes that do not have a specified cause.

When should I63.513 be used instead of related codes?

I63.513 should be used when the occlusion or stenosis of the middle cerebral arteries is bilateral and unspecified, whereas related codes should be used when the occlusion is specified as unilateral or due to a known cause.

What documentation supports I63.513?

Documentation should include clinical findings, imaging results confirming the infarction, and any relevant history of vascular disease or risk factors that may have contributed to the stroke.