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ICD-10 Guide
ICD-10 CodesI63.531

I63.531

Billable

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

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

Code Description

ICD-10 I63.531 is a billable code used to indicate a diagnosis of cerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral artery.

Key Diagnostic Point:

Cerebral infarction due to unspecified occlusion or stenosis of the right posterior cerebral artery occurs when blood flow to the right posterior cerebral artery is obstructed, leading to ischemia and subsequent brain tissue death. The posterior cerebral artery supplies blood to the occipital lobe, inferior part of the temporal lobe, and various deep structures of the brain. Clinical presentation may include visual disturbances, sensory deficits, and cognitive impairments, depending on the extent of the infarction and the areas affected. Disease progression can vary; some patients may experience rapid deterioration, while others may have a more gradual onset of symptoms. Diagnostic considerations include neuroimaging (CT or MRI) to confirm the presence of an infarction and to rule out hemorrhagic stroke. Risk factors include hypertension, diabetes, hyperlipidemia, and a history of transient ischemic attacks (TIAs). Early recognition and management are crucial to minimize long-term neurological deficits.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation
  • 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 identification of the occlusion or stenosis

Audit Risk Factors

  • Common coding errors: Misidentifying the artery involved or the type of infarction
  • Documentation gaps: Incomplete clinical notes or lack of imaging results
  • Billing challenges: Denials due to insufficient documentation or incorrect coding

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 significantly impact population health, contributing to morbidity and mortality rates associated with stroke. Quality measures focus on timely diagnosis and treatment to improve outcomes and reduce long-term disabilities. Understanding the epidemiology of strokes, including risk factors and demographics, is essential for healthcare providers to implement effective prevention strategies and allocate resources appropriately.

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 and reduce long-term disabilities. Understanding the epidemiology of strokes, including risk factors and demographics, is essential for healthcare providers to implement effective prevention strategies and allocate resources appropriately.

Reimbursement & Billing Impact

Reimbursement considerations include the patient's insurance coverage and the necessity of the services provided. Common denials may arise from insufficient documentation or incorrect coding, emphasizing the importance of accurate coding practices. Coders should ensure that all relevant clinical information is captured to support the medical necessity of the procedures billed.

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 I63.531?

I63.531 covers cerebral infarctions specifically due to occlusion or stenosis of the right posterior cerebral artery. This includes ischemic strokes resulting from embolism or thrombosis affecting this artery, leading to neurological deficits related to the areas it supplies.

When should I63.531 be used instead of related codes?

I63.531 should be used when the infarction is specifically due to occlusion or stenosis of the right posterior cerebral artery without further specification. If the occlusion is due to a different artery or if the infarction is hemorrhagic, other codes should be selected.

What documentation supports I63.531?

Documentation should include clinical findings, imaging results confirming the infarction, and details regarding the occlusion or stenosis. Neurological assessments and treatment plans should also be documented to support the diagnosis.