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ICD-10 Guide
ICD-10 CodesI65.8

I65.8

Billable

Occlusion and stenosis of other precerebral arteries

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

Code Description

ICD-10 I65.8 is a billable code used to indicate a diagnosis of occlusion and stenosis of other precerebral arteries.

Key Diagnostic Point:

I65.8 refers to occlusion and stenosis of other precerebral arteries, which are critical vessels supplying blood to the brain. This condition can lead to reduced blood flow, potentially resulting in ischemic strokes or transient ischemic attacks (TIAs). The clinical presentation may vary from asymptomatic to severe neurological deficits, depending on the extent of the occlusion or stenosis. The anatomy involved includes the carotid arteries and their branches, as well as other precerebral vessels that may not be as commonly affected. Disease progression can be insidious, with gradual narrowing leading to chronic ischemia, or it may present acutely if a complete occlusion occurs. Diagnostic considerations include imaging studies such as Doppler ultrasound, CT angiography, or MR angiography to assess blood flow and identify the location and severity of the occlusion. Clinicians must consider risk factors such as hypertension, diabetes, hyperlipidemia, and smoking, which contribute to the development of atherosclerosis in these arteries.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation to confirm occlusion or stenosis.
  • Treatment complexity: Management may involve medical therapy, lifestyle changes, or surgical interventions.
  • Documentation requirements: Detailed clinical notes and imaging reports are necessary for accurate coding.
  • Coding specificity: Requires precise documentation of the affected arteries and extent of occlusion.

Audit Risk Factors

  • Common coding errors: Misidentifying the specific artery involved or failing to document the severity.
  • Documentation gaps: Incomplete clinical notes or lack of imaging results can lead to coding inaccuracies.
  • Billing challenges: Denials may occur if documentation does not clearly support the diagnosis or if the code is not used appropriately.

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 I65.8 lies in its potential to lead to serious neurological events such as strokes, which can significantly impact patient quality of life and healthcare costs. Understanding the epidemiology of occlusion and stenosis in precerebral arteries is essential for population health management, as these conditions are often linked to modifiable risk factors. Effective management can reduce the incidence of strokes and improve overall healthcare utilization patterns.

ICD-9 vs ICD-10

The clinical significance of I65.8 lies in its potential to lead to serious neurological events such as strokes, which can significantly impact patient quality of life and healthcare costs. Understanding the epidemiology of occlusion and stenosis in precerebral arteries is essential for population health management, as these conditions are often linked to modifiable risk factors. Effective management can reduce the incidence of strokes and improve overall healthcare utilization patterns.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the occlusion and any associated treatments. Common denials may arise from insufficient documentation or incorrect coding. It is crucial to ensure that all relevant clinical information is included in the patient’s medical record to support the diagnosis and justify the medical necessity of any procedures performed. Coding best practices recommend using the most specific code available and ensuring that documentation aligns with the code selected.

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 I65.8?

I65.8 encompasses occlusion and stenosis of precerebral arteries not classified elsewhere, including conditions affecting the vertebral arteries and other branches of the carotid arteries. It is essential to differentiate these conditions from more common occlusions like those of the internal carotid artery.

When should I65.8 be used instead of related codes?

I65.8 should be used when the occlusion or stenosis is specifically identified as affecting other precerebral arteries, rather than more commonly referenced arteries like the internal carotid or vertebral arteries, which have their own specific codes.

What documentation supports I65.8?

Documentation must include imaging studies that confirm the presence of occlusion or stenosis, clinical assessments detailing symptoms, and any relevant history of risk factors contributing to vascular disease.