2025 ICD-10-CM code G45
(Active) Effective Date: N/A Diseases of the nervous system - Transient cerebral ischemic attacks and related syndromes 6 Feed
Transient cerebral ischemic attacks and related syndromes
Medical necessity for diagnostic testing and treatment of a TIA is based on the need to determine the cause of the event and prevent a future stroke.The documentation must clearly link the symptoms and findings to the diagnosis and the chosen treatment plan.
Diagnosis of TIAs and related syndromes is based on medical history, signs, symptoms, and neurological and physical examination.Further investigations may include blood tests (cholesterol and sugar levels), carotid ultrasound, CT scan, MRI, CT or MR angiography/arteriography, and echocardiography. Treatment focuses on controlling or reducing calcium and cholesterol deposits in arteries through medication, lowering stroke risk with aspirin or blood thinners, and managing blood pressure. Lifestyle changes, such as a healthy diet, increased exercise, and smoking cessation, are also encouraged.In severe cases, surgical interventions like carotid endarterectomy, carotid angioplasty, and stenting may be necessary.
In simple words: A TIA (transient ischemic attack), sometimes called a mini-stroke, happens when blood flow to part of the brain is briefly blocked.Symptoms, like weakness on one side, trouble speaking, or vision changes, come on suddenly and usually last only a few minutes or hours, up to a maximum of 24 hours. TIAs and related conditions are caused by problems with blood flow in the arteries of the brain, such as a blood clot or narrowed arteries.
Transient cerebral ischemic attacks and related syndromes refer to a sudden, temporary loss of blood flow in the arteries that supply the brain. This can be caused by plaque deposits breaking off from the inner lining of arteries, narrowing of the arteries, or blood clots blocking blood flow.TIAs and related syndromes include vertebrobasilar artery syndrome, hemispheric carotid artery syndrome, multiple and bilateral precerebral artery syndromes, amaurosis fugax, and transient global amnesia. Symptoms vary depending on the specific syndrome but can include weakness, numbness or paralysis (typically on one side of the body), slurred speech, impaired vision, dizziness, loss of balance, and sudden severe headache.Other symptoms may include temporary painless visual loss in one eye and temporary memory loss. Most TIA symptoms disappear within minutes or a few hours, but they can last up to 24 hours.
Example 1: A 65-year-old male presents with sudden onset of right-sided weakness and slurred speech that resolved within 30 minutes.He has a history of high cholesterol. A carotid ultrasound reveals significant stenosis of the left carotid artery, leading to a diagnosis of TIA related to hemispheric carotid artery syndrome., A 72-year-old female experiences temporary loss of vision in her left eye described as a curtain coming down, which resolves within an hour. This episode is diagnosed as amaurosis fugax, a form of TIA., A 50-year-old male reports an episode of sudden confusion and inability to form new memories, lasting for several hours. Neurological examination is normal after the episode resolves.This is consistent with transient global amnesia, a type of TIA.
Documentation should include details of the onset, duration, and specific symptoms experienced during the TIA.Results of any diagnostic tests (blood tests, imaging studies) and details of the neurological examination should be recorded.The provider's assessment and plan for treatment, including medication prescriptions and lifestyle recommendations, should also be documented.
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