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ICD-10 Guide
ICD-10 CodesI66.19

I66.19

Billable

Occlusion and stenosis of unspecified anterior cerebral artery

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

Code Description

ICD-10 I66.19 is a billable code used to indicate a diagnosis of occlusion and stenosis of unspecified anterior cerebral artery.

Key Diagnostic Point:

I66.19 refers to occlusion and stenosis of the unspecified anterior cerebral artery, a condition that can lead to significant neurological deficits due to reduced blood flow to the brain. The anterior cerebral artery (ACA) supplies blood to the medial portions of the frontal lobes and the superior medial parietal lobes. Clinical presentation may include symptoms such as weakness or paralysis of the lower limbs, changes in behavior, and cognitive impairments. Disease progression can vary; some patients may experience transient ischemic attacks (TIAs) or full-blown strokes, depending on the severity of the occlusion or stenosis. Diagnostic considerations include imaging studies such as MRI or CT angiography to visualize blood flow and identify blockages. Early detection and intervention are crucial to prevent irreversible brain damage and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation.
  • Treatment complexity: May involve medical management or surgical intervention.
  • Documentation requirements: Detailed clinical notes and imaging results are essential.
  • Coding specificity: Requires precise identification of the affected artery.

Audit Risk Factors

  • Common coding errors: Misidentification of the affected artery.
  • Documentation gaps: Lack of detailed clinical notes or imaging reports.
  • Billing challenges: Potential denials due to insufficient specificity.

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

Vascular Surgery

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 I66.19 lies in its potential to lead to severe neurological deficits and increased healthcare utilization due to the need for emergency interventions. Population health impact includes a higher prevalence of stroke and related disabilities, emphasizing the importance of early detection and management. Quality measures may focus on timely imaging and treatment, while epidemiological considerations highlight the need for awareness and prevention strategies in at-risk populations.

ICD-9 vs ICD-10

The clinical significance of I66.19 lies in its potential to lead to severe neurological deficits and increased healthcare utilization due to the need for emergency interventions. Population health impact includes a higher prevalence of stroke and related disabilities, emphasizing the importance of early detection and management. Quality measures may focus on timely imaging and treatment, while epidemiological considerations highlight the need for awareness and prevention strategies in at-risk populations.

Reimbursement & Billing Impact

Reimbursement may depend on the specificity of the diagnosis and the associated procedures performed. Common denials may arise from insufficient documentation or lack of clarity regarding the extent of the occlusion. It is essential to ensure that all relevant clinical notes, imaging reports, and treatment plans are included in the patient's medical record to support the claim.

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 I66.19?

I66.19 encompasses occlusion and stenosis of the anterior cerebral artery that is not specified as right or left. It may include conditions such as atherosclerosis, embolism, or thrombosis affecting blood flow.

When should I66.19 be used instead of related codes?

I66.19 should be used when the specific side of the anterior cerebral artery is not documented. If the occlusion is specified as right or left, the corresponding codes (I66.01 or I66.02) should be used.

What documentation supports I66.19?

Documentation should include clinical findings, imaging results that confirm occlusion or stenosis, and any relevant patient history that supports the diagnosis.