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ICD-10 Guide
ICD-10 CodesI63.542

I63.542

Billable

Cerebral infarction due to unspecified occlusion or stenosis of left cerebellar artery

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

Code Description

ICD-10 I63.542 is a billable code used to indicate a diagnosis of cerebral infarction due to unspecified occlusion or stenosis of left cerebellar artery.

Key Diagnostic Point:

Cerebral infarction due to unspecified occlusion or stenosis of the left cerebellar artery refers to a condition where blood flow to the left cerebellar region of the brain is obstructed, leading to tissue death (infarction). The cerebellum is responsible for coordination, balance, and fine motor control. Patients may present with symptoms such as dizziness, ataxia (lack of voluntary coordination of muscle movements), nausea, and difficulty with balance. The occlusion or stenosis may be due to various factors, including atherosclerosis, embolism, or thrombosis. Disease progression can vary; some patients may experience transient ischemic attacks (TIAs) before a full-blown infarction occurs. Diagnostic considerations include neuroimaging techniques such as CT or MRI scans to visualize the extent of the infarction and assess for potential causes. It is crucial to differentiate this condition from other types of strokes and cerebellar disorders to ensure appropriate management and treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical assessment to confirm the diagnosis.
  • Treatment complexity: Management may involve anticoagulation, rehabilitation, and monitoring for complications.
  • Documentation requirements: Detailed clinical notes and imaging reports are necessary to support the diagnosis.
  • Coding specificity: Requires precise identification of the affected artery and underlying cause.

Audit Risk Factors

  • Common coding errors: Misidentification of the affected artery or occlusion type.
  • Documentation gaps: Insufficient clinical details to support the diagnosis.
  • Billing challenges: Potential denials if documentation does not clearly establish the medical necessity.

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

Emergency 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

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. Effective management and timely intervention can improve patient outcomes and reduce healthcare utilization. Quality measures related to stroke care, such as timely imaging and rehabilitation services, are critical for enhancing care delivery and patient satisfaction. Epidemiologically, understanding the prevalence of such conditions aids in resource allocation and preventive strategies.

ICD-9 vs ICD-10

Cerebral infarctions significantly impact population health, contributing to morbidity and mortality rates associated with stroke. Effective management and timely intervention can improve patient outcomes and reduce healthcare utilization. Quality measures related to stroke care, such as timely imaging and rehabilitation services, are critical for enhancing care delivery and patient satisfaction. Epidemiologically, understanding the prevalence of such conditions aids in resource allocation and preventive strategies.

Reimbursement & Billing Impact

Cerebral infarctions significantly impact population health, contributing to morbidity and mortality rates associated with stroke. Effective management and timely intervention can improve patient outcomes and reduce healthcare utilization. Quality measures related to stroke care, such as timely imaging and rehabilitation services, are critical for enhancing care delivery and patient satisfaction. Epidemiologically, understanding the prevalence of such conditions aids in resource allocation and preventive strategies.

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 I63.542?

I63.542 covers cerebral infarctions specifically due to unspecified occlusion or stenosis of the left cerebellar artery, which may arise from various etiologies such as embolic events or thrombotic processes.

When should I63.542 be used instead of related codes?

I63.542 should be used when the infarction is confirmed to be due to occlusion or stenosis of the left cerebellar artery without a specified cause. It is distinct from codes that specify other arteries or known causes.

What documentation supports I63.542?

Documentation should include clinical findings, imaging results (CT or MRI), and a clear description of the patient's symptoms and medical history that led to the diagnosis of cerebral infarction.