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ICD-10 Guide
ICD-10 CodesI63.533

I63.533

Billable

Cerebral infarction due to unspecified occlusion or stenosis of bilateral posterior cerebral arteries

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

Code Description

ICD-10 I63.533 is a billable code used to indicate a diagnosis of cerebral infarction due to unspecified occlusion or stenosis of bilateral posterior cerebral arteries.

Key Diagnostic Point:

I63.533 refers to cerebral infarction due to unspecified occlusion or stenosis of bilateral posterior cerebral arteries. This condition arises when blood flow to the posterior cerebral arteries, which supply blood to the occipital lobe and parts of the temporal lobe, is obstructed. Clinical presentation may include visual disturbances, such as homonymous hemianopia, and cognitive deficits due to the involvement of areas responsible for processing visual information and memory. The disease progression can vary; some patients may experience sudden onset of symptoms, while others may have transient ischemic attacks (TIAs) before a full-blown infarction occurs. Diagnostic considerations include neuroimaging techniques such as MRI or CT scans to identify areas of infarction and assess the extent of occlusion or stenosis. Additionally, vascular imaging may be necessary to evaluate the underlying causes, such as atherosclerosis or embolism, contributing to the occlusion of these arteries.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging studies and differential diagnosis to rule out other causes of stroke.
  • Treatment complexity: May involve anticoagulation therapy, rehabilitation, and management of risk factors.
  • Documentation requirements: Detailed clinical notes and imaging results are essential for accurate coding.
  • Coding specificity: Requires precise documentation of the occlusion or stenosis and its bilateral nature.

Audit Risk Factors

  • Common coding errors: Misidentification of the occlusion type or laterality.
  • Documentation gaps: Incomplete clinical notes regarding symptoms and imaging findings.
  • Billing challenges: Potential denials if documentation does not clearly 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

Radiology

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

The clinical significance of I63.533 lies in its potential to cause severe neurological deficits, impacting patient quality of life and increasing healthcare utilization. Understanding the epidemiology of cerebral infarctions, particularly in populations at risk for vascular diseases, is crucial for developing effective prevention strategies. Quality measures may focus on timely diagnosis and intervention, which can significantly improve outcomes for affected individuals.

ICD-9 vs ICD-10

The clinical significance of I63.533 lies in its potential to cause severe neurological deficits, impacting patient quality of life and increasing healthcare utilization. Understanding the epidemiology of cerebral infarctions, particularly in populations at risk for vascular diseases, is crucial for developing effective prevention strategies. Quality measures may focus on timely diagnosis and intervention, which can significantly improve outcomes for affected individuals.

Reimbursement & Billing Impact

Reimbursement considerations include the need for detailed clinical notes that outline the patient's symptoms, imaging results, and treatment plans. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for imaging studies. Best practices include ensuring that all relevant clinical information is included in the patient's record and that coding accurately reflects the complexity of the condition.

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 I63.533?

I63.533 covers cerebral infarctions resulting from unspecified occlusion or stenosis of the bilateral posterior cerebral arteries, which may include ischemic strokes and related neurological deficits.

When should I63.533 be used instead of related codes?

I63.533 should be used when the occlusion or stenosis is bilateral and unspecified, differentiating it from codes that specify unilateral involvement or other types of strokes.

What documentation supports I63.533?

Documentation should include clinical findings, imaging results showing infarction, and notes on the patient's neurological status and any risk factors contributing to the condition.