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ICD-10 Guide
ICD-10 CodesI65.1

I65.1

Billable

Occlusion and stenosis of basilar artery

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

Code Description

ICD-10 I65.1 is a billable code used to indicate a diagnosis of occlusion and stenosis of basilar artery.

Key Diagnostic Point:

I65.1 refers to the occlusion and stenosis of the basilar artery, a critical vessel that supplies blood to the brainstem and cerebellum. Clinical presentation may include symptoms such as dizziness, vertigo, visual disturbances, and ataxia, which arise due to compromised cerebral blood flow. The basilar artery is formed by the union of the two vertebral arteries and is essential for supplying the posterior circulation of the brain. Disease progression can lead to severe neurological deficits, including stroke, if not addressed promptly. Diagnostic considerations include imaging studies such as MRI or CT angiography to visualize the occlusion or narrowing of the artery. Risk factors for this condition often overlap with those for other cardiovascular diseases, including hypertension, hyperlipidemia, diabetes, and smoking. Early detection and management are crucial to prevent irreversible brain damage and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging studies 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 to differentiate from other cerebrovascular conditions.

Audit Risk Factors

  • Common coding errors: Misidentification of the artery involved.
  • Documentation gaps: Incomplete clinical notes regarding symptoms and imaging.
  • Billing challenges: Potential denials due to lack of supporting documentation.

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

The clinical significance of I65.1 lies in its potential to lead to serious neurological outcomes, including stroke, which can significantly impact population health. Understanding the epidemiology of basilar artery occlusion can help healthcare providers prioritize preventive measures in at-risk populations. Quality measures may include monitoring for timely diagnosis and treatment, which can improve healthcare utilization patterns and patient outcomes.

ICD-9 vs ICD-10

The clinical significance of I65.1 lies in its potential to lead to serious neurological outcomes, including stroke, which can significantly impact population health. Understanding the epidemiology of basilar artery occlusion can help healthcare providers prioritize preventive measures in at-risk populations. Quality measures may include monitoring for timely diagnosis and treatment, which can improve healthcare utilization patterns and patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the complexity of the case and the interventions performed. Common denials arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all relevant clinical information is captured to support the claim and reduce the risk of audits.

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 I65.1?

I65.1 covers occlusion and stenosis specifically of the basilar artery, which may result from atherosclerosis, embolism, or other vascular diseases. It is critical to differentiate this from occlusions in other arteries to ensure accurate coding.

When should I65.1 be used instead of related codes?

I65.1 should be used when there is confirmed occlusion or stenosis of the basilar artery, as evidenced by imaging studies. It is important to use this code when the clinical presentation aligns with posterior circulation symptoms.

What documentation supports I65.1?

Documentation should include clinical notes detailing symptoms, imaging results confirming occlusion or stenosis of the basilar artery, and any relevant medical history that supports the diagnosis.