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ICD-10 Guide
ICD-10 CodesI66.21

I66.21

Billable

Occlusion and stenosis of right posterior cerebral artery

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

Code Description

ICD-10 I66.21 is a billable code used to indicate a diagnosis of occlusion and stenosis of right posterior cerebral artery.

Key Diagnostic Point:

I66.21 refers to the occlusion and stenosis of the right posterior cerebral artery (PCA), a critical vessel in the brain's circulatory system. The PCA supplies blood to the occipital lobe, inferior part of the temporal lobe, and various deep structures of the brain. Clinical presentation may include visual disturbances, such as homonymous hemianopia, and cognitive deficits due to ischemia in the affected areas. The disease progression can lead to significant neurological deficits if not addressed promptly. Diagnosis typically involves imaging studies, such as MRI or CT angiography, to visualize the occlusion or narrowing of the artery. Risk factors include atherosclerosis, hypertension, diabetes, and other cardiovascular diseases. Understanding the anatomy involved and the potential for collateral circulation is crucial for effective management and treatment planning.

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 necessary.
  • Coding specificity: Requires precise documentation of the affected artery.

Audit Risk Factors

  • Common coding errors: Misidentification of the affected artery.
  • Documentation gaps: Incomplete imaging or clinical notes.
  • Billing challenges: Denials due to lack of specificity or 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 I66.21 lies in its potential to cause severe neurological deficits if not treated promptly. Population health impact is notable, as conditions affecting cerebral arteries contribute significantly to stroke morbidity and mortality. Quality measures may include timely diagnosis and intervention rates, while healthcare utilization patterns reflect the need for advanced imaging and specialist consultations. Epidemiologically, understanding the prevalence of PCA occlusions can inform public health strategies aimed at reducing stroke incidence.

ICD-9 vs ICD-10

The clinical significance of I66.21 lies in its potential to cause severe neurological deficits if not treated promptly. Population health impact is notable, as conditions affecting cerebral arteries contribute significantly to stroke morbidity and mortality. Quality measures may include timely diagnosis and intervention rates, while healthcare utilization patterns reflect the need for advanced imaging and specialist consultations. Epidemiologically, understanding the prevalence of PCA occlusions can inform public health strategies aimed at reducing stroke incidence.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the case and the necessity of imaging studies. Common denials may arise from insufficient documentation or lack of clarity regarding the diagnosis. Best practices include ensuring that all relevant clinical information is included in the medical record and that the coding accurately reflects the patient's condition.

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 I66.21?

I66.21 covers conditions related to occlusion and stenosis of the right posterior cerebral artery, including ischemic strokes and transient ischemic attacks (TIAs) affecting the PCA territory.

When should I66.21 be used instead of related codes?

I66.21 should be used when there is confirmed occlusion or stenosis specifically of the right PCA, differentiating it from other cerebral artery codes based on the location and nature of the vascular issue.

What documentation supports I66.21?

Documentation should include imaging studies that confirm the occlusion or stenosis, clinical notes detailing symptoms, and any relevant history of cardiovascular disease or risk factors.