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ICD-10 Guide
ICD-10 CodesI63.10

I63.10

Billable

Cerebral infarction due to embolism of unspecified precerebral artery

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

Code Description

ICD-10 I63.10 is a billable code used to indicate a diagnosis of cerebral infarction due to embolism of unspecified precerebral artery.

Key Diagnostic Point:

Cerebral infarction due to embolism of an unspecified precerebral artery is a critical condition characterized by the obstruction of blood flow to the brain caused by an embolus originating from another site in the body. This condition typically presents with sudden onset of neurological deficits, which may include weakness, speech difficulties, and sensory loss, depending on the area of the brain affected. The anatomy involved primarily includes the carotid arteries and their branches, which supply blood to the anterior circulation of the brain. Disease progression can lead to irreversible brain damage if not promptly addressed, making timely diagnosis and intervention crucial. Diagnostic considerations include neuroimaging studies such as CT or MRI scans to confirm the presence of an infarct and to rule out hemorrhagic stroke. Additionally, risk factors such as atrial fibrillation, carotid artery disease, and other cardiovascular conditions must be evaluated to determine the source of the embolism and guide treatment strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical evaluation to confirm diagnosis.
  • Treatment complexity: May involve anticoagulation therapy, rehabilitation, and management of underlying conditions.
  • Documentation requirements: Detailed clinical notes and imaging reports are essential for accurate coding.
  • Coding specificity: Requires precise identification of the embolic source and affected artery.

Audit Risk Factors

  • Common coding errors: Misidentification of the type of stroke or embolic source.
  • Documentation gaps: Incomplete clinical notes that do not specify the embolic origin.
  • Billing challenges: Potential denials if documentation does not support the diagnosis or if the code is not used correctly.

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 infarction due to embolism significantly impacts population health, contributing to morbidity and mortality associated with stroke. It is a leading cause of disability and necessitates extensive healthcare resources for acute management and rehabilitation. Understanding the epidemiology of this condition can help in developing preventive strategies and improving quality measures in stroke care, ultimately enhancing healthcare utilization patterns.

ICD-9 vs ICD-10

Cerebral infarction due to embolism significantly impacts population health, contributing to morbidity and mortality associated with stroke. It is a leading cause of disability and necessitates extensive healthcare resources for acute management and rehabilitation. Understanding the epidemiology of this condition can help in developing preventive strategies and improving quality measures in stroke care, ultimately enhancing healthcare utilization patterns.

Reimbursement & Billing Impact

reimbursement considerations include the necessity of imaging studies and the management of risk factors. Denials may occur if the documentation does not clearly establish the diagnosis or if the coding is not aligned with the clinical findings. Best practices include regular audits of documentation and coding accuracy to minimize billing challenges.

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 I63.10?

I63.10 covers cerebral infarctions specifically due to embolism from an unspecified precerebral artery. This includes cases where the embolus may originate from the heart or other vascular sources but does not specify the exact artery involved.

When should I63.10 be used instead of related codes?

I63.10 should be used when the cerebral infarction is confirmed to be due to an embolism from a precerebral artery, and the specific artery cannot be identified. If the source is known, a more specific code should be selected.

What documentation supports I63.10?

Documentation must include clinical findings, imaging results confirming the cerebral infarction, and any relevant history of embolic sources such as atrial fibrillation or carotid artery disease.