2025 ICD-10-CM code I63
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Cerebrovascular diseases - Cerebrovascular diseases (I60-I69) Diseases of the circulatory system (I00-I99) Feed
Cerebral infarction, including occlusion and stenosis of cerebral and precerebral arteries resulting in infarction.
ICD-10 codes do not use modifiers. Modifiers are used with CPT and HCPCS codes.
Medical necessity is established by the presence of acute neurological deficits consistent with stroke, confirmed by neuroimaging studies.Treatment is medically necessary to minimize brain damage and improve patient outcomes.
Diagnosis and management of stroke, including assessment of symptoms, ordering and interpretation of diagnostic imaging (CT scan, MRI), neurological examination, and initiation of treatment (e.g., thrombolytics, anticoagulants).
In simple words: This code is for a stroke (cerebral infarction), which happens when a blood clot blocks blood flow to part of the brain.This blockage damages the brain tissue.Doctors may use additional codes to describe the exact cause and location of the stroke.
This code represents cerebral infarction, encompassing occlusion and stenosis of cerebral and precerebral arteries leading to cerebral infarction.Additional codes may be necessary to specify the cause (e.g., thrombosis, embolism), location, and laterality.Further codes should be used to identify the presence of contributing factors like alcohol abuse, tobacco use, hypertension, or prior tPA administration.Excludes neonatal cerebral infarction and chronic cerebral infarction without residual deficits.
Example 1: A 70-year-old male presents to the emergency room with sudden onset of right-sided weakness and slurred speech.A CT scan reveals a left middle cerebral artery infarction.I63.3 (Cerebral infarction due to thrombosis of a cerebral artery) is coded along with additional codes to specify the location and cause of the stroke., A 65-year-old female with a history of atrial fibrillation experiences sudden onset of visual disturbances and dizziness.An MRI reveals a right posterior cerebral artery infarction. I63.1 (Cerebral infarction due to embolism of precerebral arteries) is coded, along with codes for atrial fibrillation and the specific location., An 80-year-old patient is admitted with a history of hypertension and diabetes.A CT scan reveals an acute infarct in the left parietal lobe without clear evidence of thrombosis or embolism.I63.5 (Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries) along with codes for hypertension and diabetes would be appropriate.
Detailed history of the event, including time of onset of symptoms, neurological exam findings, results of neuroimaging studies (CT scan, MRI), and any treatment administered (e.g., tPA).Supporting documentation of risk factors such as hypertension, diabetes, atrial fibrillation, and smoking status.
** While I63 is a broad code, appropriate sub-coding based on the etiology and location of the infarction is critical for accurate billing and reimbursement.Always confirm the diagnosis with appropriate neuroimaging studies (CT or MRI) before coding.Outpatient coding of I63.* should be avoided unless supported by confirmatory diagnostic testing.
- Revenue Code: Revenue codes will vary based on the specific services rendered and the payer.
- RVU: RVUs are not directly associated with ICD-10 codes.Reimbursement is dependent on the procedures performed and the payer's fee schedule.
- Global Days: Not applicable to ICD-10 codes. Global periods are associated with surgical procedures coded with CPT codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.Fee schedules are determined by payers and apply to procedure codes (CPT, HCPCS).
- Specialties:Neurology, Neurosurgery
- Place of Service:Emergency Room - Hospital, Inpatient Hospital