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ICD-10 Guide
ICD-10 CodesI63.412

I63.412

Billable

Cerebral infarction due to embolism of left middle cerebral artery

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

Code Description

ICD-10 I63.412 is a billable code used to indicate a diagnosis of cerebral infarction due to embolism of left middle cerebral artery.

Key Diagnostic Point:

Cerebral infarction due to embolism of the left middle cerebral artery (MCA) is a critical condition characterized by the obstruction of blood flow to the brain, specifically affecting the left MCA territory. Clinically, patients may present with sudden onset of neurological deficits, including contralateral hemiparesis, sensory loss, and aphasia, depending on the extent of the infarction. The left MCA supplies a significant portion of the lateral aspect of the cerebral hemisphere, and its occlusion can lead to severe functional impairments. The 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. Additionally, identifying the source of the embolism, which may be cardiac (e.g., atrial fibrillation) or from atherosclerotic plaques, is crucial for management and prevention of future strokes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical evaluation to confirm diagnosis.
  • Treatment complexity: Management may involve anticoagulation, rehabilitation, and addressing underlying conditions.
  • 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 side of the infarction.
  • Documentation gaps: Lack of detailed clinical notes on the patient's presentation and imaging findings.
  • 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

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 rates associated with stroke. It is a leading cause of long-term disability, affecting patients' quality of life and increasing healthcare utilization. Understanding the epidemiology of strokes, including risk factors such as hypertension and atrial fibrillation, is crucial for developing preventive strategies and improving quality measures in healthcare systems.

ICD-9 vs ICD-10

Cerebral infarction due to embolism significantly impacts population health, contributing to morbidity and mortality rates associated with stroke. It is a leading cause of long-term disability, affecting patients' quality of life and increasing healthcare utilization. Understanding the epidemiology of strokes, including risk factors such as hypertension and atrial fibrillation, is crucial for developing preventive strategies and improving quality measures in healthcare systems.

Reimbursement & Billing Impact

reimbursement and minimize audit risks.

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 I63.412?

I63.412 specifically covers cerebral infarction due to embolism affecting the left middle cerebral artery. This includes ischemic strokes resulting from embolic events originating from cardiac sources or other vascular conditions.

When should I63.412 be used instead of related codes?

I63.412 should be used when the cerebral infarction is confirmed to be due to embolism affecting the left MCA. It is important to differentiate it from other codes that may pertain to right-sided strokes or other types of cerebral infarctions.

What documentation supports I63.412?

Documentation should include clinical notes detailing the patient's symptoms, results from neuroimaging studies confirming the infarction, and any relevant laboratory findings that indicate the source of the embolism.