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ICD-10 Guide
ICD-10 CodesI63.53

I63.53

Non-billable

Cerebral infarction due to unspecified occlusion or stenosis of posterior cerebral artery

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

Code Description

ICD-10 I63.53 is a used to indicate a diagnosis of cerebral infarction due to unspecified occlusion or stenosis of posterior cerebral artery.

Key Diagnostic Point:

Cerebral infarction due to unspecified occlusion or stenosis of the posterior cerebral artery is a condition characterized by the interruption of blood flow to the posterior cerebral artery, leading to ischemic damage in the brain. Clinically, patients may present with symptoms such as visual disturbances, sensory deficits, and cognitive impairments, depending on the area of the brain affected. The posterior cerebral artery supplies blood to the occipital lobe and parts of the temporal lobe, making infarctions in this region particularly impactful on visual processing and memory functions. Disease progression can vary, with some patients experiencing transient ischemic attacks (TIAs) before a full-blown infarction occurs. Diagnostic considerations include neuroimaging techniques such as MRI or CT scans to visualize the infarct and assess the extent of damage. Additionally, vascular imaging may be required to identify occlusions or stenosis in the posterior cerebral artery. Early diagnosis and intervention are crucial to minimize long-term neurological deficits and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation to confirm diagnosis.
  • Treatment complexity: May involve anticoagulation, rehabilitation, and management of risk factors.
  • Documentation requirements: Detailed clinical notes and imaging reports are essential.
  • Coding specificity: Requires precise identification of the occlusion or stenosis.

Audit Risk Factors

  • Common coding errors: Misidentification of the artery involved or failure to document the occlusion type.
  • Documentation gaps: Incomplete clinical notes or lack of imaging results.
  • Billing challenges: Potential denials due to insufficient evidence of the infarction's cause.

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 infarctions significantly impact population health, contributing to morbidity and mortality associated with stroke. Understanding the epidemiology of posterior cerebral artery occlusions is crucial for healthcare providers, as these conditions can lead to long-term disabilities and increased healthcare utilization. Quality measures focusing on timely diagnosis and intervention can improve outcomes for affected patients, emphasizing the importance of effective management strategies in reducing the burden of stroke-related complications.

ICD-9 vs ICD-10

Cerebral infarctions significantly impact population health, contributing to morbidity and mortality associated with stroke. Understanding the epidemiology of posterior cerebral artery occlusions is crucial for healthcare providers, as these conditions can lead to long-term disabilities and increased healthcare utilization. Quality measures focusing on timely diagnosis and intervention can improve outcomes for affected patients, emphasizing the importance of effective management strategies in reducing the burden of stroke-related complications.

Reimbursement & Billing Impact

Cerebral infarctions significantly impact population health, contributing to morbidity and mortality associated with stroke. Understanding the epidemiology of posterior cerebral artery occlusions is crucial for healthcare providers, as these conditions can lead to long-term disabilities and increased healthcare utilization. Quality measures focusing on timely diagnosis and intervention can improve outcomes for affected patients, emphasizing the importance of effective management strategies in reducing the burden of stroke-related complications.

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 I63.53?

I63.53 covers cerebral infarctions specifically due to occlusion or stenosis of the posterior cerebral artery, which may arise from various etiologies such as atherosclerosis, embolism, or thrombosis. It is important to differentiate this from infarctions due to other arteries or causes.

When should I63.53 be used instead of related codes?

I63.53 should be used when the infarction is specifically due to occlusion or stenosis of the posterior cerebral artery and when the specific cause is not documented. If the occlusion is due to a different artery or if the cause is known, other codes should be selected.

What documentation supports I63.53?

Documentation should include clinical findings, imaging results confirming the infarction, and any relevant history of vascular disease. Detailed notes on the patient's symptoms and neurological examination findings are also critical.