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2025 ICD-10-CM code I67.850

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL).

Code I67.850 should be used as the primary code when CADASIL is the principal diagnosis.Additional codes may be used to capture associated manifestations such as strokes, TIAs, dementia, migraines, or epilepsy.

Medical necessity for services related to CADASIL should be justified by the need to diagnose, manage, and treat the symptoms and complications of the disease, including preventing future strokes and managing cognitive decline.

Diagnosis and management of CADASIL typically falls under the purview of neurologists, geneticists, and other specialists involved in cerebrovascular care. Clinicians should take a detailed family history and consider genetic testing to confirm the diagnosis.

IMPORTANT:Prior to the creation of I67.850, CADASIL was coded using various codes for related symptoms or diagnoses, such as vascular dementia (F01.-), stroke (I63.-), or epilepsy (G40.-).

In simple words: CADASIL is a genetic condition that affects blood vessels in the brain, causing migraines, strokes, and eventually problems with thinking and memory. It's passed down through families and is caused by a faulty gene.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary cerebrovascular disease characterized by recurrent strokes and migraines, leading to cognitive decline and dementia. It is caused by mutations in the NOTCH3 gene, leading to thickening and fibrosis of blood vessels in the brain.

Example 1: A 45-year-old patient presents with recurrent migraines, mood changes, and cognitive decline.A family history of strokes suggests CADASIL, which is confirmed by genetic testing.The code I67.850 is used., A patient with a confirmed diagnosis of CADASIL via genetic testing is hospitalized following a transient ischemic attack (TIA). I67.850 is used in conjunction with codes for the TIA (e.g., G45.9) and any other related conditions., A 60-year-old patient with a known family history of CADASIL presents with progressive dementia and gait disturbances. Imaging reveals characteristic white matter changes, consistent with the disease. I67.850 is used to document the underlying cause of the dementia.

Documentation should include relevant family history, clinical findings (e.g., migraines, cognitive deficits, stroke symptoms), neuroimaging results (e.g., MRI findings), and results of genetic testing for NOTCH3 mutations.

** Genetic counseling is often recommended for individuals diagnosed with CADASIL and their family members.As of December 1st, 2024,ongoing research may influence future diagnostic and treatment options for this condition.Refer to updated clinical guidelines and resources for the most current information.

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