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ICD-10 Guide
ICD-10 CodesI63.331

I63.331

Billable

Cerebral infarction due to thrombosis of right posterior cerebral artery

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

Code Description

ICD-10 I63.331 is a billable code used to indicate a diagnosis of cerebral infarction due to thrombosis of right posterior cerebral artery.

Key Diagnostic Point:

Cerebral infarction due to thrombosis of the right posterior cerebral artery is a type of ischemic stroke characterized by the obstruction of blood flow to the brain tissue supplied by this artery. Clinically, patients may present with symptoms such as visual disturbances, sensory deficits, and cognitive impairments, depending on the extent of the infarction and the areas of the brain affected. The posterior cerebral artery supplies blood to the occipital lobe and parts of the temporal lobe, which are crucial for vision and memory. Disease progression can vary; some patients may experience rapid onset of symptoms, while others may have a more gradual decline. Diagnostic considerations include neuroimaging techniques such as CT or MRI scans to confirm the presence of an infarct and to rule out hemorrhagic strokes. Additionally, risk factors such as hypertension, diabetes, and hyperlipidemia should be assessed as they contribute to the likelihood of thrombosis in cerebral arteries.

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 risk factors.
  • Documentation requirements: Detailed clinical notes and imaging reports are necessary.
  • Coding specificity: Requires precise coding to differentiate from other types of strokes.

Audit Risk Factors

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

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Cerebral infarctions, including those due to thrombosis of the right posterior cerebral artery, significantly impact population health, leading to increased morbidity and mortality. Effective management and timely intervention can improve outcomes and reduce healthcare utilization. Quality measures focus on rapid diagnosis and treatment, which are critical in minimizing long-term disability and enhancing recovery in affected patients.

ICD-9 vs ICD-10

Cerebral infarctions, including those due to thrombosis of the right posterior cerebral artery, significantly impact population health, leading to increased morbidity and mortality. Effective management and timely intervention can improve outcomes and reduce healthcare utilization. Quality measures focus on rapid diagnosis and treatment, which are critical in minimizing long-term disability and enhancing recovery in affected patients.

Reimbursement & Billing Impact

Reimbursement considerations include the patient's insurance coverage and the necessity of imaging studies. Common denials may arise from inadequate documentation or failure to meet medical necessity criteria. Best practices include ensuring that all clinical notes are complete, that imaging results are attached, and that the coding accurately reflects the patient's condition 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 I63.331?

I63.331 specifically covers cerebral infarction due to thrombosis of the right posterior cerebral artery, which may manifest as visual field deficits, memory issues, and other neurological impairments.

When should I63.331 be used instead of related codes?

I63.331 should be used when there is clear documentation of thrombosis affecting the right posterior cerebral artery, differentiating it from other stroke types or locations.

What documentation supports I63.331?

Documentation should include clinical findings, imaging results confirming the infarction, and a detailed account of the patient's symptoms and medical history.