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ICD-10 Guide
ICD-10 CodesI65.01

I65.01

Billable

Occlusion and stenosis of right vertebral artery

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

Code Description

ICD-10 I65.01 is a billable code used to indicate a diagnosis of occlusion and stenosis of right vertebral artery.

Key Diagnostic Point:

I65.01 refers to the occlusion and stenosis of the right vertebral artery, a critical vessel supplying blood to the posterior circulation of the brain. Clinically, patients may present with symptoms such as dizziness, vertigo, visual disturbances, or even signs of posterior circulation stroke, including ataxia or altered consciousness. The vertebral arteries originate from the subclavian arteries and ascend through the cervical vertebrae, merging to form the basilar artery. Disease progression can lead to significant ischemic events if blood flow is compromised. Diagnostic considerations include imaging studies such as Doppler ultrasound, CT angiography, or MRI to assess blood flow and identify stenosis or occlusion. Risk factors include atherosclerosis, hypertension, and diabetes, which can contribute to vascular changes over time. Early detection and management are crucial to prevent severe neurological deficits.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation.
  • Treatment complexity: May involve medical management or surgical intervention.
  • Documentation requirements: Detailed clinical notes and imaging reports are essential.
  • Coding specificity: Requires precise documentation of laterality and severity.

Audit Risk Factors

  • Common coding errors: Misidentifying the affected artery or failing to document laterality.
  • Documentation gaps: Incomplete clinical notes or lack of imaging reports.
  • Billing challenges: Denials due to insufficient documentation or unclear clinical rationale.

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

Interventional 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 I65.01 lies in its potential to lead to serious neurological deficits if not diagnosed and managed promptly. Population health impact includes the prevalence of vertebral artery disease, which can contribute to stroke risk in at-risk populations. Quality measures focus on timely diagnosis and intervention to improve patient outcomes. Understanding healthcare utilization patterns related to vertebral artery occlusion can help in resource allocation and preventive strategies in at-risk groups.

ICD-9 vs ICD-10

The clinical significance of I65.01 lies in its potential to lead to serious neurological deficits if not diagnosed and managed promptly. Population health impact includes the prevalence of vertebral artery disease, which can contribute to stroke risk in at-risk populations. Quality measures focus on timely diagnosis and intervention to improve patient outcomes. Understanding healthcare utilization patterns related to vertebral artery occlusion can help in resource allocation and preventive strategies in at-risk groups.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the complexity of the case and the interventions performed. Common denials may arise from insufficient documentation or lack of clarity regarding the diagnosis. It is essential to ensure that all documentation aligns with the coding to support the medical necessity of the services rendered. Best practices include thorough clinical notes and timely submission of claims.

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 I65.01?

I65.01 covers occlusion and stenosis specifically of the right vertebral artery, which may lead to ischemic events affecting the brain's posterior circulation. It is important to differentiate this from occlusions in other arteries or bilateral involvement.

When should I65.01 be used instead of related codes?

I65.01 should be used when there is a confirmed diagnosis of occlusion or stenosis of the right vertebral artery, particularly when imaging studies support this finding. It should be differentiated from codes for left-sided or bilateral conditions.

What documentation supports I65.01?

Documentation should include clinical findings, imaging results confirming occlusion or stenosis of the right vertebral artery, and any relevant patient history that supports the diagnosis, such as risk factors and presenting symptoms.