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ICD-10 Guide
ICD-10 CodesI63.49

I63.49

Billable

Cerebral infarction due to embolism of other cerebral artery

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

Code Description

ICD-10 I63.49 is a billable code used to indicate a diagnosis of cerebral infarction due to embolism of other cerebral artery.

Key Diagnostic Point:

Cerebral infarction due to embolism of other cerebral artery refers to a condition where a blood clot or other debris travels through the bloodstream and lodges in a cerebral artery, leading to a blockage that restricts blood flow to a specific area of the brain. This results in ischemia and subsequent infarction, which can cause neurological deficits depending on the affected area. The clinical presentation may include sudden onset of weakness, speech difficulties, loss of coordination, or altered consciousness. The anatomy involved primarily includes the cerebral arteries, which branch from the internal carotid and vertebral arteries. Disease progression can vary; some patients may experience transient ischemic attacks (TIAs) before a full stroke, while others may have a sudden and severe onset of symptoms. Diagnostic considerations include neuroimaging studies such as CT or MRI to confirm the presence of an infarct and to rule out hemorrhagic stroke. Laboratory tests may also be performed to identify underlying conditions such as atrial fibrillation or hypercoagulable states that could contribute to embolism.

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 type of stroke or embolic source.
  • Documentation gaps may arise if the source of embolism is not clearly stated.
  • Billing challenges can occur if the clinical documentation does not support the severity or type of stroke coded.

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 infarctions due to embolism significantly impact population health, contributing to morbidity and mortality rates associated with stroke. Understanding the epidemiology of this condition is crucial for healthcare providers, as it informs preventive strategies and resource allocation. Quality measures related to timely diagnosis and treatment of strokes can improve patient outcomes and reduce healthcare utilization, emphasizing the importance of accurate coding and documentation.

ICD-9 vs ICD-10

Cerebral infarctions due to embolism significantly impact population health, contributing to morbidity and mortality rates associated with stroke. Understanding the epidemiology of this condition is crucial for healthcare providers, as it informs preventive strategies and resource allocation. Quality measures related to timely diagnosis and treatment of strokes can improve patient outcomes and reduce healthcare utilization, emphasizing the importance of accurate coding and documentation.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity for imaging and treatment is well-documented. Common denials may arise from insufficient documentation linking the diagnosis to the treatment provided. Best practices include maintaining clear and concise clinical notes, ensuring all relevant tests and procedures are documented, and using precise coding to reflect the patient's condition accurately.

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 I63.49?

I63.49 covers cerebral infarctions specifically due to embolism from sources other than the internal carotid or vertebral arteries, which may include cardiac sources or other systemic emboli. It is crucial to document the source of the embolism for accurate coding.

When should I63.49 be used instead of related codes?

I63.49 should be used when the cerebral infarction is confirmed to be due to an embolism from an unspecified or other cerebral artery, distinguishing it from codes that specify the artery or those that indicate a different etiology such as thrombosis.

What documentation supports I63.49?

Documentation must include a definitive diagnosis of cerebral infarction, neuroimaging results confirming the infarct, and a clear indication of the embolic source. Additionally, clinical notes should detail the patient's symptoms and any relevant medical history.