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ICD-10 Guide
ICD-10 CodesI63.549

I63.549

Billable

Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebellar artery

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

Code Description

ICD-10 I63.549 is a billable code used to indicate a diagnosis of cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebellar artery.

Key Diagnostic Point:

Cerebral infarction due to unspecified occlusion or stenosis of an unspecified cerebellar artery refers to a type of stroke that occurs when blood flow to the cerebellum is obstructed, leading to tissue death. The cerebellum is responsible for coordination, balance, and motor control. Patients may present with symptoms such as dizziness, ataxia, nausea, and difficulty with coordination. The progression of the disease can vary; some patients may experience transient ischemic attacks (TIAs) before a full-blown infarction occurs. Diagnostic considerations include neuroimaging techniques such as CT or MRI scans to identify the infarction and assess the extent of damage. Additionally, vascular imaging may be necessary to evaluate the occlusion or stenosis of the cerebellar arteries. Understanding the underlying cause of the infarction is crucial for treatment and prevention of future strokes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical evaluation to determine the cause of the infarction.
  • Treatment complexity: Management may involve anticoagulation, rehabilitation, and addressing risk factors.
  • Documentation requirements: Requires detailed clinical documentation to support the diagnosis and treatment plan.
  • Coding specificity: While I63.549 is specific, it lacks detail regarding the exact artery involved, which can complicate coding.

Audit Risk Factors

  • Common coding errors: Misidentification of the specific artery involved can lead to incorrect coding.
  • Documentation gaps: Insufficient documentation of symptoms and imaging findings may result in denials.
  • Billing challenges: Lack of clarity in the diagnosis may lead to reimbursement issues.

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 significantly impact population health, contributing to morbidity and mortality rates associated with stroke. Understanding the epidemiology of strokes, including risk factors such as hypertension and diabetes, is crucial for prevention strategies. Quality measures related to stroke care, such as timely intervention and rehabilitation, are essential for improving patient outcomes and reducing healthcare utilization. The management of cerebral infarctions, including I63.549, plays a vital role in addressing the broader implications of cardiovascular diseases.

ICD-9 vs ICD-10

Cerebral infarctions significantly impact population health, contributing to morbidity and mortality rates associated with stroke. Understanding the epidemiology of strokes, including risk factors such as hypertension and diabetes, is crucial for prevention strategies. Quality measures related to stroke care, such as timely intervention and rehabilitation, are essential for improving patient outcomes and reducing healthcare utilization. The management of cerebral infarctions, including I63.549, plays a vital role in addressing the broader implications of cardiovascular diseases.

Reimbursement & Billing Impact

Reimbursement may depend on the clarity of the clinical rationale and the completeness of the documentation. Common denials may arise from insufficient detail regarding the patient's symptoms or the imaging studies performed. It is essential to ensure that all relevant clinical information is included in the medical record to support the coding and billing process. Familiarity with payer-specific guidelines can also enhance the likelihood of successful reimbursement.

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 I63.549?

I63.549 covers cerebral infarction due to unspecified occlusion or stenosis of the cerebellar artery, which may result from various conditions such as atherosclerosis, embolism, or thrombosis. It is important to note that the specific cause of occlusion or stenosis is not documented.

When should I63.549 be used instead of related codes?

I63.549 should be used when the specific cerebellar artery involved is not documented, and the occlusion or stenosis is unspecified. If the documentation specifies the artery or the cause, a more specific code should be selected.

What documentation supports I63.549?

Documentation should include clinical findings, imaging results showing the infarction, and any relevant history of vascular disease. Detailed notes on the patient's symptoms and the clinical rationale for the diagnosis are essential.