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ICD-10 Guide
ICD-10 CodesI66.13

I66.13

Billable

Occlusion and stenosis of bilateral anterior cerebral arteries

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

Code Description

ICD-10 I66.13 is a billable code used to indicate a diagnosis of occlusion and stenosis of bilateral anterior cerebral arteries.

Key Diagnostic Point:

I66.13 refers to occlusion and stenosis of bilateral anterior cerebral arteries, a condition characterized by the narrowing or blockage of the arteries that supply blood to the anterior portion of the brain. This condition can lead to significant neurological deficits, including cognitive impairment, motor dysfunction, and increased risk of stroke. The anterior cerebral arteries are crucial for supplying blood to the medial portions of the frontal lobes and the superior medial parietal lobes. Clinical presentation may include symptoms such as weakness, sensory loss, and changes in behavior or personality. Disease progression can vary, with some patients experiencing acute events while others may have chronic symptoms due to gradual stenosis. Diagnostic considerations include imaging studies such as MRI or CT angiography to assess blood flow and identify occlusions. Early detection and management are critical 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, surgical intervention, or rehabilitation.
  • Documentation requirements: Detailed clinical notes and imaging results are necessary.
  • Coding specificity: Requires precise documentation of the location and nature of the occlusion.

Audit Risk Factors

  • Common coding errors: Misidentification of unilateral vs. bilateral occlusions.
  • Documentation gaps: Incomplete clinical notes or lack of imaging reports.
  • Billing challenges: Potential for denials if documentation does not support the severity or specifics of the condition.

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 I66.13 lies in its potential to cause severe neurological impairment and increase the risk of stroke, impacting patient quality of life. Population health considerations include the prevalence of cardiovascular diseases that contribute to this condition, emphasizing the need for preventive measures and early intervention. Quality measures may focus on timely diagnosis and management of occlusive diseases, while healthcare utilization patterns reflect the need for imaging and specialist consultations in affected populations.

ICD-9 vs ICD-10

The clinical significance of I66.13 lies in its potential to cause severe neurological impairment and increase the risk of stroke, impacting patient quality of life. Population health considerations include the prevalence of cardiovascular diseases that contribute to this condition, emphasizing the need for preventive measures and early intervention. Quality measures may focus on timely diagnosis and management of occlusive diseases, while healthcare utilization patterns reflect the need for imaging and specialist consultations in affected populations.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the occlusion, the necessity for imaging studies, and any treatments administered. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all relevant clinical information is captured, including patient history, examination findings, and treatment plans, 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 I66.13?

I66.13 covers conditions related to occlusion and stenosis of both anterior cerebral arteries, which may include atherosclerosis, embolism, or thrombosis leading to reduced blood flow and potential ischemic events.

When should I66.13 be used instead of related codes?

I66.13 should be used when there is documented occlusion or stenosis affecting both anterior cerebral arteries, differentiating it from unilateral codes which only pertain to one artery.

What documentation supports I66.13?

Documentation must include clinical findings, imaging results showing bilateral occlusion or stenosis, and any relevant history of cardiovascular disease or stroke risk factors.