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ICD-10 Guide
ICD-10 CodesI63.52

I63.52

Non-billable

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

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

Code Description

ICD-10 I63.52 is a used to indicate a diagnosis of cerebral infarction due to unspecified occlusion or stenosis of anterior cerebral artery.

Key Diagnostic Point:

Cerebral infarction due to unspecified occlusion or stenosis of the anterior cerebral artery is a condition characterized by the interruption of blood flow to the anterior cerebral artery, leading to ischemia and subsequent infarction of the brain tissue supplied by this artery. Clinically, patients may present with symptoms such as unilateral weakness, sensory deficits, and cognitive impairments, depending on the extent and location of the infarction. The anterior cerebral artery supplies the medial portions of the frontal lobes and superior medial parietal lobes, and occlusion can result in contralateral motor and sensory deficits, particularly affecting the lower limbs. Disease progression can vary; some patients may recover partially or fully, while others may experience significant long-term disabilities. 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 deficits. Understanding the underlying vascular pathology, including occlusion or stenosis, is crucial for effective management and prevention of future strokes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation to confirm diagnosis.
  • Treatment complexity: May involve anticoagulation, rehabilitation, and management of risk factors.
  • Documentation requirements: Detailed clinical notes and imaging reports are essential.
  • Coding specificity: Requires precise documentation of the type and location of the infarction.

Audit Risk Factors

  • Common coding errors: Misidentification of the type of stroke.
  • Documentation gaps: Incomplete clinical notes regarding the patient's symptoms and imaging results.
  • Billing challenges: Potential denials if documentation does not support 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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Cerebral infarction due to occlusion or stenosis of the anterior cerebral artery has significant clinical implications, as it can lead to long-term disability and increased healthcare utilization. The condition is a major contributor to morbidity and mortality in the population, emphasizing the need for effective prevention and management strategies. Quality measures related to stroke care, including timely intervention and rehabilitation, are crucial for improving patient outcomes and reducing the burden on healthcare systems.

ICD-9 vs ICD-10

Cerebral infarction due to occlusion or stenosis of the anterior cerebral artery has significant clinical implications, as it can lead to long-term disability and increased healthcare utilization. The condition is a major contributor to morbidity and mortality in the population, emphasizing the need for effective prevention and management strategies. Quality measures related to stroke care, including timely intervention and rehabilitation, are crucial for improving patient outcomes and reducing the burden on healthcare systems.

Reimbursement & Billing Impact

Reimbursement considerations include the need for thorough clinical documentation that supports the diagnosis of cerebral infarction due to unspecified occlusion or stenosis. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for imaging studies. Best practices include maintaining clear and detailed clinical notes, ensuring that all relevant tests and treatments are documented, and verifying that the coding aligns with the services rendered.

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 I63.52?

I63.52 covers cerebral infarctions resulting from unspecified occlusion or stenosis of the anterior cerebral artery, which may include conditions such as transient ischemic attacks (TIAs) and full-blown strokes that are not attributed to a specific embolic source.

When should I63.52 be used instead of related codes?

I63.52 should be used when the cerebral infarction is confirmed to be due to occlusion or stenosis of the anterior cerebral artery without a specified cause. If the cause is known, such as embolism, then a different code should be selected.

What documentation supports I63.52?

Documentation should include clinical findings, imaging results confirming the infarction, and notes detailing the patient's symptoms and any risk factors for cerebrovascular disease.