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ICD-10 Guide
ICD-10 CodesI63.312

I63.312

Billable

Cerebral infarction due to thrombosis of left middle cerebral artery

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

Code Description

ICD-10 I63.312 is a billable code used to indicate a diagnosis of cerebral infarction due to thrombosis of left middle cerebral artery.

Key Diagnostic Point:

Cerebral infarction due to thrombosis of the left middle cerebral artery (MCA) is a critical condition that arises when a thrombus obstructs blood flow in this major cerebral artery, leading to ischemic damage in the corresponding brain regions. Clinically, patients may present with sudden onset of neurological deficits, including contralateral hemiparesis, sensory loss, aphasia, and visual field deficits, depending on the area of the brain affected. The left MCA supplies blood to significant areas involved in language and motor control, which can result in profound functional impairments. Disease progression can vary; some patients may experience transient ischemic attacks (TIAs) prior to a full-blown stroke, while others may have a rapid decline. Diagnostic considerations include neuroimaging techniques such as CT or MRI to confirm the presence of an infarct and to rule out hemorrhagic stroke. Early intervention is crucial to minimize brain damage and improve outcomes, often involving thrombolytic therapy or mechanical thrombectomy if presented within the therapeutic window.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misidentifying the affected artery or failing to document the acute nature of the infarction.
  • Documentation gaps may arise from insufficient detail in clinical notes regarding the patient's neurological status.
  • Billing challenges can occur if the documentation does not clearly support the diagnosis or if the treatment provided is not adequately captured.

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

Emergency Medicine

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 thrombosis of the left middle cerebral artery has significant clinical implications, affecting not only the individual patient but also broader population health. It contributes to high rates of morbidity and mortality associated with stroke, necessitating effective prevention and management strategies. Quality measures focus on timely intervention and rehabilitation, while healthcare utilization patterns reflect the need for acute care services and long-term support for affected individuals. Epidemiologically, this condition underscores the importance of addressing risk factors such as hypertension, diabetes, and hyperlipidemia in at-risk populations.

ICD-9 vs ICD-10

Cerebral infarction due to thrombosis of the left middle cerebral artery has significant clinical implications, affecting not only the individual patient but also broader population health. It contributes to high rates of morbidity and mortality associated with stroke, necessitating effective prevention and management strategies. Quality measures focus on timely intervention and rehabilitation, while healthcare utilization patterns reflect the need for acute care services and long-term support for affected individuals. Epidemiologically, this condition underscores the importance of addressing risk factors such as hypertension, diabetes, and hyperlipidemia in at-risk populations.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is supported by appropriate medical necessity criteria. Common denials may arise from insufficient documentation or failure to demonstrate the acute nature of the condition. Best practices include thorough clinical notes that detail the patient's symptoms, diagnostic tests performed, and the rationale for treatment decisions, ensuring compliance with payer requirements.

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 I63.312?

I63.312 specifically covers cerebral infarction due to thrombosis of the left middle cerebral artery, which can manifest as various neurological deficits depending on the extent and location of the infarction.

When should I63.312 be used instead of related codes?

I63.312 should be used when there is clear documentation of a cerebral infarction specifically due to thrombosis of the left middle cerebral artery, differentiating it from other types of strokes or infarctions.

What documentation supports I63.312?

Documentation should include clinical findings of neurological deficits, imaging results confirming the infarction in the left MCA territory, and treatment details that indicate the acute nature of the event.