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ICD-10 Guide
ICD-10 CodesI63.439

I63.439

Billable

Cerebral infarction due to embolism of unspecified posterior cerebral artery

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

Code Description

ICD-10 I63.439 is a billable code used to indicate a diagnosis of cerebral infarction due to embolism of unspecified posterior cerebral artery.

Key Diagnostic Point:

Cerebral infarction due to embolism of the unspecified posterior cerebral artery is a condition characterized by the obstruction of blood flow to the brain's posterior cerebral artery, leading to ischemia and subsequent tissue death. Clinically, patients may present with sudden onset of neurological deficits, which can include visual disturbances, sensory loss, or motor weakness, depending on the specific areas of the brain affected. The posterior cerebral artery supplies blood to the occipital lobe and parts of the temporal lobe, and infarction in this region can lead to significant cognitive and sensory impairments. The disease progression can vary; some patients may experience rapid deterioration, while others may have a more gradual onset of symptoms. Diagnostic considerations include neuroimaging studies such as CT or MRI to confirm the presence of an infarct and to rule out other causes of neurological symptoms. Additionally, identifying the source of the embolism, which may originate from the heart or large vessels, is crucial for appropriate management and prevention of future events.

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 artery involved or failing to document the embolic source.
  • Documentation gaps may arise if the clinical notes do not clearly describe the patient's symptoms or the imaging findings.
  • Billing challenges can occur if the code is not supported by adequate clinical evidence or if the documentation does not meet payer requirements.

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 due to embolism significantly impact population health, contributing to morbidity and mortality rates associated with stroke. Quality measures focus on timely diagnosis and intervention, which can improve patient outcomes and reduce long-term disability. Understanding the epidemiology of this condition helps healthcare providers allocate resources effectively and implement preventive measures, particularly in high-risk populations.

ICD-9 vs ICD-10

Cerebral infarctions due to embolism significantly impact population health, contributing to morbidity and mortality rates associated with stroke. Quality measures focus on timely diagnosis and intervention, which can improve patient outcomes and reduce long-term disability. Understanding the epidemiology of this condition helps healthcare providers allocate resources effectively and implement preventive measures, particularly in high-risk populations.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is supported by the clinical documentation and that all relevant tests are coded appropriately. Common denials may arise from insufficient documentation or lack of clarity regarding the embolic source. Best practices include maintaining detailed notes on patient encounters and ensuring that all diagnostic codes are substantiated by the medical record to facilitate smooth billing processes.

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 I63.439?

I63.439 covers cerebral infarction specifically due to embolism affecting the posterior cerebral artery, which may result from various conditions such as atrial fibrillation, carotid artery disease, or other embolic sources.

When should I63.439 be used instead of related codes?

I63.439 should be used when the embolism's specific artery is not documented, distinguishing it from codes that specify the right or left posterior cerebral artery.

What documentation supports I63.439?

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