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ICD-10 Guide
ICD-10 CodesI67.5

I67.5

Billable

Moyamoya disease

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

Code Description

ICD-10 I67.5 is a billable code used to indicate a diagnosis of moyamoya disease.

Key Diagnostic Point:

Moyamoya disease is a progressive cerebrovascular disorder characterized by stenosis or occlusion of the internal carotid arteries and their proximal branches, leading to the formation of a network of collateral vessels that resemble a 'puff of smoke' on angiography, hence the name 'Moyamoya' which means 'puff of smoke' in Japanese. Clinically, patients may present with transient ischemic attacks (TIAs), strokes, or neurological deficits due to reduced cerebral blood flow. The disease predominantly affects children and young adults, but it can occur at any age. The anatomy involved includes the internal carotid arteries and the anterior and middle cerebral arteries. Disease progression can lead to recurrent strokes and significant morbidity. Diagnosis is typically confirmed through imaging studies such as magnetic resonance angiography (MRA) or digital subtraction angiography (DSA), which visualize the characteristic vascular changes. Early diagnosis and intervention are crucial to prevent severe neurological outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moyamoya disease can be challenging to diagnose due to its nonspecific symptoms and the need for advanced imaging techniques.
  • Treatment complexity: Management may involve surgical interventions such as revascularization procedures, which require careful consideration of patient-specific factors.
  • Documentation requirements: Comprehensive documentation is necessary to support the diagnosis and treatment plan, including imaging results and clinical evaluations.
  • Coding specificity: I67.5 is specific to Moyamoya disease, but coders must differentiate it from other cerebrovascular disorders.

Audit Risk Factors

  • Common coding errors: Misclassification of Moyamoya disease as a general cerebrovascular accident.
  • Documentation gaps: Incomplete clinical notes or lack of imaging reports can lead to denials.
  • Billing challenges: Complex treatment regimens may result in billing discrepancies if not properly documented.

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

Moyamoya disease has significant clinical implications, particularly in younger populations, leading to increased healthcare utilization due to recurrent strokes and neurological interventions. Understanding its epidemiology is crucial, as it may vary by ethnicity and geographic location. Quality measures focusing on early diagnosis and effective management can improve patient outcomes and reduce the burden on healthcare systems.

ICD-9 vs ICD-10

Moyamoya disease has significant clinical implications, particularly in younger populations, leading to increased healthcare utilization due to recurrent strokes and neurological interventions. Understanding its epidemiology is crucial, as it may vary by ethnicity and geographic location. Quality measures focusing on early diagnosis and effective management can improve patient outcomes and reduce the burden on healthcare systems.

Reimbursement & Billing Impact

Reimbursement may vary based on the complexity of the surgical interventions, such as revascularization techniques. Documentation must clearly outline the diagnosis, treatment plan, and any imaging studies performed. Common denials may arise from insufficient documentation or coding errors, particularly if the condition is misclassified. Coders should ensure that all relevant procedures are accurately captured to maximize reimbursement and minimize audit risks.

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 I67.5?

I67.5 specifically covers Moyamoya disease, which includes the characteristic occlusion of the internal carotid arteries and the development of collateral circulation. It does not cover other forms of cerebrovascular disease.

When should I67.5 be used instead of related codes?

I67.5 should be used when a patient is diagnosed with Moyamoya disease, characterized by specific angiographic findings. It should not be used for general strokes or transient ischemic attacks without the distinct features of Moyamoya.

What documentation supports I67.5?

Documentation should include clinical evaluations, imaging studies (MRA or DSA), and any relevant history of ischemic events. Detailed notes on symptoms and neurological assessments are also essential.