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ICD-10 Guide
ICD-10 CodesI63.11

I63.11

Non-billable

Cerebral infarction due to embolism of vertebral artery

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

Code Description

ICD-10 I63.11 is a used to indicate a diagnosis of cerebral infarction due to embolism of vertebral artery.

Key Diagnostic Point:

Cerebral infarction due to embolism of the vertebral artery is a type of ischemic stroke characterized by the obstruction of blood flow to the brain caused by an embolus originating from another part of the body. The vertebral arteries, which supply blood to the posterior part of the brain, can become occluded due to various factors including atherosclerosis, cardiac arrhythmias, or other embolic sources. Clinically, patients may present with symptoms such as sudden onset of weakness, numbness, difficulty speaking, or loss of coordination. The progression of the disease can vary, with some patients experiencing transient ischemic attacks (TIAs) before a full-blown stroke occurs. Diagnostic considerations include neuroimaging studies such as CT or MRI to confirm the presence of an infarct and to rule out hemorrhagic stroke. Additionally, vascular imaging may be performed to assess the vertebral arteries for stenosis or occlusion. Early recognition and management are crucial to minimize neurological deficits and improve outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation
  • Treatment complexity: May involve anticoagulation or surgical intervention
  • Documentation requirements: Detailed clinical notes and imaging results needed
  • Coding specificity: Specific to embolism of the vertebral artery

Audit Risk Factors

  • Common coding errors: Misidentifying the type of stroke
  • Documentation gaps: Incomplete clinical notes or missing imaging reports
  • Billing challenges: Denials due to lack of specificity or supporting documentation

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 of the vertebral artery has significant clinical implications, contributing to morbidity and mortality in affected populations. Understanding the epidemiology of this condition is crucial for improving healthcare outcomes and resource allocation. Quality measures related to timely diagnosis and treatment can enhance patient care and reduce long-term disability associated with strokes.

ICD-9 vs ICD-10

Cerebral infarction due to embolism of the vertebral artery has significant clinical implications, contributing to morbidity and mortality in affected populations. Understanding the epidemiology of this condition is crucial for improving healthcare outcomes and resource allocation. Quality measures related to timely diagnosis and treatment can enhance patient care and reduce long-term disability associated with strokes.

Reimbursement & Billing Impact

Reimbursement considerations include the need for comprehensive documentation that outlines the patient's clinical presentation, imaging studies performed, and any treatments administered. Common denials may arise from insufficient documentation or failure to specify the embolic source. Best practices include ensuring that all relevant clinical notes are complete and that imaging reports are attached to support 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 I63.11?

I63.11 specifically covers cerebral infarction resulting from an embolism in the vertebral artery. This includes embolic strokes that may arise from cardiac sources, such as atrial fibrillation, or from atherosclerotic plaques.

When should I63.11 be used instead of related codes?

I63.11 should be used when the cerebral infarction is specifically due to an embolism in the vertebral artery, as opposed to other types of strokes such as those caused by thrombosis or hemorrhage.

What documentation supports I63.11?

Documentation should include clinical findings, imaging results confirming the infarction, and any relevant history of embolic sources, such as cardiac conditions or vascular disease.