2025 ICD-10-CM code I69.91
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Cerebrovascular diseases - Sequelae of unspecified cerebrovascular diseases Diseases of the circulatory system (I00-I99) Feed
Cognitive deficits following unspecified cerebrovascular disease.
Modifiers may be applicable depending on the circumstances of the encounter and the specific cognitive deficits observed. Refer to the current year's CPT codebook and relevant payer guidelines.
Medical necessity will be determined by the clinical presentation, the severity of the cognitive deficits, the impact on the patient's daily life and functioning, and the need for further diagnostic workup or treatment.Supporting documentation must justify the diagnosis and demonstrate that the cognitive impairment is attributable to an unspecified cerebrovascular disease and warrants medical management.
Neurologist, physician specializing in cerebrovascular disease, or other appropriate healthcare professional.
- Diseases of the circulatory system (I00-I99)
- I69 (Sequelae of cerebrovascular disease) > I69.9 (Sequelae of unspecified cerebrovascular diseases) > I69.91 (Cognitive deficits following unspecified cerebrovascular disease)
In simple words: This code describes thinking problems (like trouble remembering, focusing, or solving problems) that happen after a problem with blood flow to the brain, but the specific type of brain problem isn't known.
This code is used to classify cognitive deficits that occur as a consequence of an unspecified cerebrovascular disease.It encompasses a range of cognitive impairments, including attention and concentration deficits, memory problems, visuospatial deficits, psychomotor slowing, frontal lobe dysfunction, and social or emotional cognitive impairments.The underlying cerebrovascular event is not specified.
Example 1: A 70-year-old patient presents with progressive memory loss and difficulty with spatial orientation following a period of unexplained confusion and dizziness.Imaging studies reveal evidence of chronic cerebrovascular disease but do not identify a specific causative event (e.g., stroke, TIA).I69.91 is used to code the cognitive deficits., A 65-year-old patient with a history of hypertension and poorly controlled diabetes experiences a gradual decline in executive function and attention.Neuropsychological testing reveals significant impairments in planning, problem-solving, and sustained attention.Brain imaging is non-specific, showing evidence of small vessel disease. I69.91 is the appropriate code., An 80-year-old patient falls and sustains a minor head injury.Although imaging is negative for acute intracranial hemorrhage, the patient develops significant cognitive difficulties, including memory deficits, apraxia, and difficulty with language comprehension.Given the absence of clear traumatic etiology for cognitive impairment and the possibility of underlying vascular contributions, I69.91 might be considered as a secondary diagnosis. Consult the treating physician's documentation to confirm.
Detailed history of cognitive decline, neurological examination findings, neuropsychological testing results, brain imaging reports (MRI, CT), and records of any other relevant investigations (e.g., blood tests).
** This code is for cognitive deficits following unspecified cerebrovascular disease.When a specific cerebrovascular event is identified (e.g., stroke, intracerebral hemorrhage), a more specific code should be used.
- Payment Status: Active
- Modifier TC rule: Not applicable to this ICD-10-CM code.
- Specialties:Neurology, Geriatric medicine, Internal medicine
- Place of Service:Office, Hospital (inpatient or outpatient), Skilled nursing facility, other relevant clinical settings