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ICD-10 Guide
ICD-10 CodesI66.01

I66.01

Billable

Occlusion and stenosis of right middle cerebral artery

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

Code Description

ICD-10 I66.01 is a billable code used to indicate a diagnosis of occlusion and stenosis of right middle cerebral artery.

Key Diagnostic Point:

I66.01 refers to the occlusion and stenosis of the right middle cerebral artery (MCA), a critical vessel supplying blood to a significant portion of the lateral aspect of the cerebral hemisphere. Clinically, patients may present with neurological deficits, including contralateral hemiparesis, sensory loss, and aphasia, depending on the extent of the occlusion and the areas of the brain affected. The MCA is responsible for motor and sensory functions of the face and upper limbs, and its impairment can lead to significant disability. Disease progression may involve gradual stenosis due to atherosclerosis or acute occlusion from embolic events. Diagnostic considerations include neuroimaging techniques such as CT or MRI angiography to visualize the occlusion and assess collateral circulation. Early identification and management are crucial to prevent further neurological damage and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging studies and clinical correlation.
  • Treatment complexity: May involve medical management, rehabilitation, or surgical interventions.
  • Documentation requirements: Detailed clinical notes and imaging reports are essential.
  • Coding specificity: Requires precise documentation of the affected artery and condition.

Audit Risk Factors

  • Common coding errors: Misidentification of the affected artery.
  • Documentation gaps: Incomplete clinical notes or lack of imaging reports.
  • Billing challenges: Potential denials if documentation does not support the diagnosis.

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

Interventional Radiology

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 I66.01 is profound, as occlusion of the right middle cerebral artery can lead to substantial morbidity and mortality. Understanding this condition is crucial for population health, as it contributes to the overall burden of stroke-related disabilities. Quality measures often focus on timely diagnosis and intervention, which can significantly affect healthcare utilization patterns and improve patient outcomes in affected populations.

ICD-9 vs ICD-10

The clinical significance of I66.01 is profound, as occlusion of the right middle cerebral artery can lead to substantial morbidity and mortality. Understanding this condition is crucial for population health, as it contributes to the overall burden of stroke-related disabilities. Quality measures often focus on timely diagnosis and intervention, which can significantly affect healthcare utilization patterns and improve patient outcomes in affected populations.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the severity of the condition and the treatment provided. Common denials may arise from insufficient documentation or incorrect coding. Best practices include ensuring that all clinical notes are thorough and that the coding accurately reflects the patient's condition and treatment plan.

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 I66.01?

I66.01 encompasses conditions related to the occlusion or stenosis of the right middle cerebral artery, including ischemic strokes and transient ischemic attacks (TIAs) that specifically affect this artery.

When should I66.01 be used instead of related codes?

I66.01 should be used when there is confirmed occlusion or stenosis of the right middle cerebral artery, as opposed to I66.00, which is for unspecified middle cerebral artery conditions.

What documentation supports I66.01?

Documentation should include imaging studies confirming the occlusion or stenosis, clinical notes detailing neurological assessments, and any relevant laboratory results that support the diagnosis.