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ICD-10 Guide
ICD-10 CodesI65.29

I65.29

Billable

Occlusion and stenosis of unspecified carotid artery

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

Code Description

ICD-10 I65.29 is a billable code used to indicate a diagnosis of occlusion and stenosis of unspecified carotid artery.

Key Diagnostic Point:

I65.29 refers to the occlusion and stenosis of an unspecified carotid artery, which is a significant condition affecting the blood flow to the brain. The carotid arteries, located on either side of the neck, are crucial for supplying oxygenated blood to the brain. When these arteries become occluded or narrowed due to atherosclerosis, thrombosis, or other vascular diseases, it can lead to serious complications such as transient ischemic attacks (TIAs) or strokes. Clinically, patients may present with symptoms such as dizziness, weakness, or sudden changes in vision, although many may remain asymptomatic until a significant event occurs. The disease progression can vary, with some patients experiencing gradual narrowing over years, while others may have acute occlusions. Diagnostic considerations include imaging studies such as Doppler ultrasound, CT angiography, or MR angiography to assess blood flow and identify the extent of stenosis. Early detection and management are critical to prevent severe outcomes associated with carotid artery disease.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation to confirm diagnosis.
  • Treatment complexity: May involve medical management, lifestyle changes, or surgical interventions.
  • Documentation requirements: Detailed clinical documentation is necessary to support diagnosis and treatment.
  • Coding specificity: Requires precise coding to differentiate from other carotid artery conditions.

Audit Risk Factors

  • Common coding errors: Misidentification of the specific artery involved.
  • Documentation gaps: Lack of detailed clinical notes to support the diagnosis.
  • Billing challenges: Potential for denials if the documentation does not clearly establish medical necessity.

Specialty Focus

Medical Specialties

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

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

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 I65.29 lies in its potential to lead to severe neurological events such as strokes, which can have devastating effects on patient health and quality of life. The prevalence of carotid artery disease is increasing with an aging population, making it a critical focus for healthcare providers. Effective management and early intervention can significantly reduce the risk of stroke, thereby improving population health outcomes and reducing healthcare costs associated with acute care.

ICD-9 vs ICD-10

The clinical significance of I65.29 lies in its potential to lead to severe neurological events such as strokes, which can have devastating effects on patient health and quality of life. The prevalence of carotid artery disease is increasing with an aging population, making it a critical focus for healthcare providers. Effective management and early intervention can significantly reduce the risk of stroke, thereby improving population health outcomes and reducing healthcare costs associated with acute care.

Reimbursement & Billing Impact

Reimbursement may be affected by the specificity of the documentation provided. Common denials can occur if the documentation does not clearly outline the patient's symptoms or the rationale for the procedures performed. It is essential to ensure that all relevant clinical information is included in the patient's medical record to support the diagnosis and any associated procedures.

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 I65.29?

I65.29 encompasses occlusion and stenosis of the carotid artery that is not specified as right or left. This includes conditions resulting from atherosclerosis, embolism, or other vascular diseases that lead to reduced blood flow to the brain.

When should I65.29 be used instead of related codes?

I65.29 should be used when the specific carotid artery affected is not documented. If the right or left carotid artery is specified, the appropriate specific code (I65.21 or I65.22) should be used instead.

What documentation supports I65.29?

Documentation should include clinical findings, imaging results, and any symptoms experienced by the patient. Detailed notes on the patient's history, risk factors, and treatment plans are essential to support the use of this code.