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ICD-10 Guide
ICD-10 CodesI65.9

I65.9

Billable

Occlusion and stenosis of unspecified precerebral artery

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

Code Description

ICD-10 I65.9 is a billable code used to indicate a diagnosis of occlusion and stenosis of unspecified precerebral artery.

Key Diagnostic Point:

I65.9 refers to occlusion and stenosis of an unspecified precerebral artery, which is a condition characterized by the narrowing or blockage of arteries that supply blood to the brain. This condition can lead to reduced blood flow, increasing the risk of ischemic strokes and transient ischemic attacks (TIAs). The precerebral arteries include the internal carotid arteries and their branches, which are crucial for cerebral perfusion. Clinical presentation may vary, with some patients experiencing no symptoms, while others may present with neurological deficits, dizziness, or transient loss of consciousness. Disease progression can be insidious, often exacerbated by risk factors such as hypertension, diabetes, hyperlipidemia, and smoking. Diagnosis typically involves imaging studies such as Doppler ultrasound, CT angiography, or MR angiography to assess blood flow and identify the location and severity of the occlusion or stenosis. Early identification and management are essential to prevent serious complications, including stroke.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation to confirm diagnosis.
  • Treatment complexity: May involve medical management or surgical intervention depending on severity.
  • Documentation requirements: Detailed clinical notes and imaging results are necessary.
  • Coding specificity: Limited specificity as it does not indicate the exact artery affected.

Audit Risk Factors

  • Common coding errors: Misidentifying the specific artery involved.
  • Documentation gaps: Incomplete clinical notes regarding symptoms and imaging findings.
  • Billing challenges: Potential denials due to lack of specificity or supporting documentation.

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

The clinical significance of I65.9 lies in its association with increased stroke risk, which has substantial implications for population health. Effective management of occlusion and stenosis can reduce healthcare utilization and improve patient outcomes. Quality measures may focus on timely diagnosis and intervention to prevent strokes, highlighting the importance of early detection in at-risk populations. Epidemiologically, understanding the prevalence of this condition can aid in resource allocation and preventive strategies.

ICD-9 vs ICD-10

The clinical significance of I65.9 lies in its association with increased stroke risk, which has substantial implications for population health. Effective management of occlusion and stenosis can reduce healthcare utilization and improve patient outcomes. Quality measures may focus on timely diagnosis and intervention to prevent strokes, highlighting the importance of early detection in at-risk populations. Epidemiologically, understanding the prevalence of this condition can aid in resource allocation and preventive strategies.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity for imaging and treatment is clearly documented. Common denials may arise from insufficient documentation or lack of specificity in coding. Best practices include maintaining comprehensive clinical notes, ensuring that all imaging studies are properly coded, and verifying that the diagnosis aligns with the services billed.

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 I65.9?

I65.9 covers occlusion and stenosis of unspecified precerebral arteries, which may include conditions leading to reduced cerebral blood flow, such as atherosclerosis or embolism affecting the internal carotid arteries or their branches.

When should I65.9 be used instead of related codes?

I65.9 should be used when the specific artery affected is not documented or when the occlusion or stenosis is generalized without specification. If a specific artery is identified, related codes like I65.0 or I65.1 should be used.

What documentation supports I65.9?

Documentation should include clinical findings, imaging results that indicate occlusion or stenosis, and any relevant patient history that supports the diagnosis, including risk factors and symptoms.