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ICD-10 Guide
ICD-10 CodesI63.031

I63.031

Billable

Cerebral infarction due to thrombosis of right carotid artery

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

Code Description

ICD-10 I63.031 is a billable code used to indicate a diagnosis of cerebral infarction due to thrombosis of right carotid artery.

Key Diagnostic Point:

Cerebral infarction due to thrombosis of the right carotid artery is a critical condition characterized by the obstruction of blood flow to the brain, specifically due to a thrombus (blood clot) forming in the right carotid artery. This artery is responsible for supplying blood to the right side of the brain, and its occlusion can lead to significant neurological deficits. Clinical presentation may include sudden onset of weakness or numbness on the left side of the body, difficulty speaking, and visual disturbances. The anatomy involved includes the carotid arteries, which bifurcate into the internal and external carotid arteries, with the internal carotid supplying the brain. Disease progression can vary; some patients may experience transient ischemic attacks (TIAs) prior to a full stroke, while others may present with acute symptoms. Diagnostic considerations include imaging studies such as CT or MRI to confirm the presence of an infarct and Doppler ultrasound to assess blood flow in the carotid arteries. Early diagnosis and intervention are crucial to minimize brain damage and improve outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical assessment to confirm diagnosis.
  • Treatment complexity: May involve anticoagulation therapy, surgical intervention, or rehabilitation.
  • Documentation requirements: Detailed clinical notes and imaging results are necessary.
  • Coding specificity: Requires precise coding to differentiate from other types of strokes.

Audit Risk Factors

  • Common coding errors: Misidentification of stroke type or location.
  • Documentation gaps: Incomplete clinical notes or lack of imaging results.
  • Billing challenges: Potential denials due to insufficient documentation or incorrect code selection.

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

Cerebral infarctions due to thrombosis of the carotid artery have significant clinical implications, affecting patient quality of life and increasing healthcare utilization. This condition is a leading cause of morbidity and mortality in the population, necessitating effective management strategies. Quality measures focus on timely diagnosis and treatment to reduce the risk of long-term disability and improve overall health outcomes.

ICD-9 vs ICD-10

Cerebral infarctions due to thrombosis of the carotid artery have significant clinical implications, affecting patient quality of life and increasing healthcare utilization. This condition is a leading cause of morbidity and mortality in the population, necessitating effective management strategies. Quality measures focus on timely diagnosis and treatment to reduce the risk of long-term disability and improve overall health outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the condition and the need for potential surgical interventions. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for imaging studies. Best practices include ensuring that all clinical notes are complete and that imaging results are clearly linked to the diagnosis.

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 I63.031?

I63.031 specifically covers cerebral infarction resulting from thrombosis in the right carotid artery, which may lead to ischemic stroke. It does not include infarctions caused by embolism or other vascular issues.

When should I63.031 be used instead of related codes?

I63.031 should be used when the infarction is specifically due to thrombosis of the right carotid artery, distinguishing it from codes for infarctions due to embolism or those affecting other arteries.

What documentation supports I63.031?

Documentation should include clinical findings, imaging results confirming the presence of a thrombus in the right carotid artery, and any neurological assessments performed.