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ICD-10 Guide
ICD-10 CodesI67.850

I67.850

Billable

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy

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

Code Description

ICD-10 I67.850 is a billable code used to indicate a diagnosis of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.

Key Diagnostic Point:

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary condition characterized by progressive degeneration of small blood vessels in the brain, leading to recurrent strokes, cognitive decline, and psychiatric symptoms. The condition is caused by mutations in the NOTCH3 gene, which affects vascular smooth muscle cells. Clinically, patients may present with migraines, mood disturbances, and progressive dementia, often beginning in mid-adulthood. The disease progression typically involves the development of subcortical infarcts and leukoencephalopathy, observable through neuroimaging techniques such as MRI, which reveal white matter changes and lacunar infarcts. Diagnostic considerations include family history, clinical symptoms, and genetic testing for NOTCH3 mutations. Early diagnosis is crucial for management and counseling of affected individuals and their families, as the condition is inherited in an autosomal dominant pattern.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires genetic testing and neuroimaging for confirmation.
  • Treatment complexity: Management is symptomatic and may involve multidisciplinary care.
  • Documentation requirements: Detailed family history and clinical findings are essential.
  • Coding specificity: Requires precise coding to differentiate from other cerebrovascular diseases.

Audit Risk Factors

  • Common coding errors: Misclassification with other cerebrovascular conditions.
  • Documentation gaps: Incomplete family history or lack of genetic testing documentation.
  • Billing challenges: Potential denials if the diagnosis is not well-supported by clinical evidence.

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

Genetics

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

CADASIL has significant clinical implications, affecting not only the individual patient but also their families due to its hereditary nature. The condition contributes to increased healthcare utilization due to recurrent strokes and cognitive decline, impacting population health. Quality measures may focus on early diagnosis and management strategies to mitigate the effects of the disease, emphasizing the importance of genetic counseling and support for affected families.

ICD-9 vs ICD-10

CADASIL has significant clinical implications, affecting not only the individual patient but also their families due to its hereditary nature. The condition contributes to increased healthcare utilization due to recurrent strokes and cognitive decline, impacting population health. Quality measures may focus on early diagnosis and management strategies to mitigate the effects of the disease, emphasizing the importance of genetic counseling and support for affected families.

Reimbursement & Billing Impact

Reimbursement may vary based on the payer, and it is essential to ensure that all clinical evidence is clearly documented to avoid denials. Common denials may arise from insufficient documentation of the genetic component or misclassification of the condition. Best practices include using precise coding and maintaining comprehensive patient records to support the diagnosis and treatment provided.

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 I67.850?

I67.850 specifically covers CADASIL, which includes symptoms such as recurrent strokes, cognitive impairment, and psychiatric disorders due to small vessel disease in the brain.

When should I67.850 be used instead of related codes?

I67.850 should be used when CADASIL is confirmed through genetic testing or when clinical features strongly suggest this condition, differentiating it from other cerebrovascular diseases.

What documentation supports I67.850?

Documentation should include a detailed family history of cerebrovascular disease, clinical symptoms consistent with CADASIL, neuroimaging findings, and results from genetic testing for NOTCH3 mutations.