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ICD-10 Guide
ICD-10 CodesI63.139

I63.139

Billable

Cerebral infarction due to embolism of unspecified carotid artery

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

Code Description

ICD-10 I63.139 is a billable code used to indicate a diagnosis of cerebral infarction due to embolism of unspecified carotid artery.

Key Diagnostic Point:

Cerebral infarction due to embolism of the unspecified carotid artery refers to a blockage in the blood supply to the brain caused by an embolus originating from the carotid artery, which is responsible for supplying blood to the brain. Clinically, patients may present with sudden onset neurological deficits, which can include weakness, numbness, difficulty speaking, or loss of coordination. The anatomy involved includes the carotid arteries, which bifurcate into the internal and external carotid arteries. The internal carotid artery supplies blood to the anterior circulation of the brain. Disease progression can lead to irreversible brain damage if not promptly treated, emphasizing the importance of rapid diagnosis and intervention. Diagnostic considerations include imaging studies such as CT or MRI to confirm the presence of an infarct and to rule out hemorrhagic stroke. Additionally, Doppler ultrasound may be utilized to assess carotid artery patency and identify potential sources of embolism.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical assessment to confirm the diagnosis.
  • Treatment complexity: Management may involve anticoagulation therapy, surgical intervention, or rehabilitation.
  • Documentation requirements: Detailed documentation of symptoms, imaging results, and treatment plans is essential.
  • Coding specificity: Requires precise coding to differentiate from other types of strokes.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of stroke or embolism source.
  • Documentation gaps: Incomplete clinical notes or lack of imaging reports.
  • Billing challenges: Potential denials due to insufficient documentation supporting the diagnosis.

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 has significant clinical implications, affecting patient morbidity and mortality rates. It is a leading cause of disability and can strain healthcare resources due to the need for acute care, rehabilitation, and long-term management. Understanding the epidemiology of this condition helps in developing preventive strategies and improving patient outcomes through quality measures focused on timely diagnosis and treatment.

ICD-9 vs ICD-10

Cerebral infarction due to embolism has significant clinical implications, affecting patient morbidity and mortality rates. It is a leading cause of disability and can strain healthcare resources due to the need for acute care, rehabilitation, and long-term management. Understanding the epidemiology of this condition helps in developing preventive strategies and improving patient outcomes through quality measures focused on timely diagnosis and treatment.

Reimbursement & Billing Impact

Reimbursement considerations involve ensuring that the diagnosis is clearly supported by clinical evidence. Common denials may occur if documentation does not adequately reflect the severity of the condition or if there are discrepancies in the coding. Best practices include thorough documentation of all clinical encounters and ensuring that all relevant tests and procedures are coded accurately to avoid billing issues.

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 I63.139?

I63.139 covers cerebral infarction specifically due to embolism from an unspecified carotid artery. It includes conditions where there is a sudden blockage leading to ischemia in the brain, resulting in neurological deficits.

When should I63.139 be used instead of related codes?

I63.139 should be used when the source of the embolism is not specified as coming from the right or left carotid artery. If the source is known, the specific code for that artery should be used.

What documentation supports I63.139?

Documentation must include clinical findings, imaging results confirming cerebral infarction, and any relevant history of embolic events. Detailed notes on neurological assessments and treatment plans are also necessary.