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ICD-10 Guide
ICD-10 CodesI63.50

I63.50

Billable

Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery

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

Code Description

ICD-10 I63.50 is a billable code used to indicate a diagnosis of cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery.

Key Diagnostic Point:

Cerebral infarction due to unspecified occlusion or stenosis of an unspecified cerebral artery is a condition characterized by the interruption of blood flow to a part of the brain, leading to tissue death (infarction). This can occur due to various factors, including atherosclerosis, embolism, or thrombosis, but in this case, the specific cause is not identified. The clinical presentation may include sudden onset of neurological deficits such as weakness, numbness, difficulty speaking, or loss of coordination, depending on the area of the brain affected. The anatomy involved primarily includes the cerebral arteries, which supply blood to the brain. Disease progression can vary; some patients may recover fully, while others may experience long-term disabilities or complications such as recurrent strokes. Diagnostic considerations include imaging studies like CT or MRI to confirm the presence of an infarct and to rule out other conditions. Additionally, risk factors such as hypertension, diabetes, and hyperlipidemia should be assessed to manage and prevent further cerebrovascular events.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical assessment to confirm diagnosis.
  • Treatment complexity: Management may involve anticoagulants, rehabilitation, and addressing risk factors.
  • Documentation requirements: Detailed clinical notes and imaging reports are essential.
  • Coding specificity: Limited specificity as the cause and location of occlusion are unspecified.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of stroke or occlusion.
  • Documentation gaps: Incomplete clinical notes or lack of imaging results.
  • Billing challenges: Potential denials due to insufficient documentation of the condition.

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

Internal 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 infarctions significantly impact population health, contributing to morbidity and mortality rates associated with stroke. Quality measures focus on timely diagnosis and treatment to improve outcomes. Healthcare utilization patterns show increased emergency department visits and hospital admissions for stroke-related conditions. Epidemiologically, stroke remains a leading cause of disability, highlighting the importance of prevention and management strategies.

ICD-9 vs ICD-10

Cerebral infarctions significantly impact population health, contributing to morbidity and mortality rates associated with stroke. Quality measures focus on timely diagnosis and treatment to improve outcomes. Healthcare utilization patterns show increased emergency department visits and hospital admissions for stroke-related conditions. Epidemiologically, stroke remains a leading cause of disability, highlighting the importance of prevention and management strategies.

Reimbursement & Billing Impact

Reimbursement considerations include the need for clear evidence of the cerebral infarction and the patient's medical history. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for imaging studies. Best practices include ensuring that all clinical notes are complete and that imaging results are readily available to support the diagnosis.

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 I63.50?

I63.50 covers cerebral infarctions resulting from unspecified occlusions or stenosis of cerebral arteries, which may include ischemic strokes without a clearly defined cause. It is important to differentiate this from other types of strokes, such as hemorrhagic strokes or those with identified causes.

When should I63.50 be used instead of related codes?

I63.50 should be used when the specific cause of the cerebral infarction is unknown or unspecified. If the occlusion or stenosis is identified, more specific codes such as I63.51 or I63.52 should be used.

What documentation supports I63.50?

Documentation should include detailed clinical notes describing the patient's symptoms, results from imaging studies confirming the infarction, and any relevant medical history that may contribute to the diagnosis.