ICD-10 Codes for Reporting Cerebral Infarction

The article provides a detailed overview of cerebral infarction – including its causes, symptoms, types, and ICD-10 codes.

Regarded as a serious, life-threatening condition, cerebral infarction occurs due to the disruption or interruption in the blood flow to a part of the brain due to problems with the blood vessels that supply it. Lack of adequate blood supply to the brain cells prevents the brain tissues from getting oxygen and other vital nutrients and brain cells begin to die off in minutes. Cerebral infarction is considered a serious medical emergency. If left untreated, it can result in serious brain damage, long-term disability and even death. Neurology medical billing and coding can be challenging. Neurologists or other specialists treating this condition rely on experienced medical billing companies to submit accurate claims and get reimbursed appropriately.

Cerebral infarction is also called ischemic stroke. Reduced blood flow to the brain is caused by atherosclerosis or thickening of the arteries which occurs due to the formation of fatty plaque (atheromas) in the blood vessels. This fatty deposits can cause a thrombus or blood clot in an artery that supplies blood to the brain or in another part of the body. In due course, a piece of this clot may break away and travel to the blood vessels in the brain where it deposits and forms a cerebral embolism. People with high blood pressure and cholesterol are at high risk of suffering cerebral infarction. Other risk factors include - smoking, obesity, a family history of heart disease, diabetes and excessive alcohol consumption.

Types of Ischemic Stroke

According to reports from the Centers for Disease Control and Prevention (2019 statistics), about 87 percent of strokes are ischemic strokes. Women have a higher lifetime risk of stroke than men. The two most common types of ischemic strokes are thrombotic and embolic.

Thrombotic Stroke - Nearly half of all strokes are thrombotic strokes. Thrombotic strokes are caused when a clot forms in one of the arteries supplying blood to the brain and blocks blood flow.

Embolic Stroke – In the case of an embolic stroke, the clot forms in an artery outside the brain (usually in the heart or neck arteries). The clot travels in the blood stream and obstructs a blood vessel in or leading to the brain.

Signs and Symptoms

In most cases, ischemic strokes occur rapidly over minutes to hours, and immediate medical care is vital. The sooner the person having a stroke gets care, the better will be the treatment outcome. For this reason, it is important to identify the signs of this condition at an early stage. Common signs and symptoms include -

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
• Confusion and trouble speaking
• Vision problems, such as trouble seeing in one or both eyes with vision blackened or blurred, or double vision
• Trouble walking
• Loss of balance or coordination
• Dizziness, loss of balance or coordination
• Severe headache with no known cause

In addition to the persistence of the problems listed above, people may also experience other symptoms like – bladder or bowel control problems, paralysis or weakness on one or both sides of the body, pain in the hands and feet (that gets worse with movement and temperature changes), trouble controlling or expressing emotions and depression.

Diagnosing and Treating Ischemic Stroke

A stroke can progress rapidly. It is important to get a proper diagnosis and treatment within the first 3 hours of symptoms appearing. Diagnosis of an ischemic stroke is based on a detailed history of events, physical examination, analysis of symptoms, and review of previous medical history. A neurological exam will also be conducted to see how the stroke is affecting the patient’s nervous system. Imaging tests, including magnetic resonance imaging (MRI) and computed tomography (CT) scan, carotid ultrasound, cerebral angiogram and echocardiogram will be done to get a detailed picture of the brain. Further testing may include - electrical activity tests (including electroencephalogram and evoked potential tests). In addition, tests such as angiography (to check the health of the blood vessels) and echocardiography (to monitor the heart) will be performed.

People who have symptoms of a stroke need emergency medical care. Immediate medical attention may prevent life-threatening complications and more widespread brain damage. It is estimated that for each minute a stroke goes untreated, the blood flow to the brain continues to be blocked and a person loses about 1.9 neurons. This could potentially affect one’s ability to speak, move, memorize and respond to different situations. Early diagnosis and timely recognition of symptoms can help in better disease management. In emergency treatment for ischemic stroke within the first three hours after symptoms begin, the patient may be administered medications like antiplatelet and anticoagulants, clot-breaking drugs, tissue plasminogen activator (tPA), antiplatelet drugs, anticoagulants, statins and blood pressure drugs) - to dissolve the clot. A surgical procedure, known as thrombectomy may also be required to treat brain swelling and reduce the risk of further bleeding, if this was the cause of the stroke.

ICD-10 Codes for Ischemic Stroke

Neurologists, Neuro-radiologists, Neurosurgeons or physicians who diagnose, screen and treat ischemic stroke must carefully document these tests and procedures using the correct medical codes. Billing and coding services offered by established medical billing companies can help physicians in using the correct codes for their medical billing process. ICD-10 codes for ischemic stroke include –

I63 Cerebral infarction

I63.0 Cerebral infarction due to thrombosis of precerebral arteries

• I63.00 Cerebral infarction due to thrombosis of unspecified precerebral artery
• I63.01 Cerebral infarction due to thrombosis of vertebral artery

I63.02 Cerebral infarction due to thrombosis of basilar artery

I63.03 Cerebral infarction due to thrombosis of carotid artery

I63.09 Cerebral infarction due to thrombosis of other precerebral artery

I63.1 Cerebral infarction due to embolism of precerebral arteries

• I63.10 Cerebral infarction due to embolism of unspecified precerebral artery
• I63.11 Cerebral infarction due to embolism of vertebral artery
• I63.12 Cerebral infarction due to embolism of basilar artery
• I63.13 Cerebral infarction due to embolism of carotid artery
• I63.19 Cerebral infarction due to embolism of other precerebral artery

I63.2 Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries

• I63.20 Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries
• I63.21 Cerebral infarction due to unspecified occlusion or stenosis of vertebral arteries
• I63.22 Cerebral infarction due to unspecified occlusion or stenosis of basilar artery
• I63.23 Cerebral infarction due to unspecified occlusion or stenosis of carotid arteries
• I63.29 Cerebral infarction due to unspecified occlusion or stenosis of other precerebral arteries

I63.3 Cerebral infarction due to thrombosis of cerebral arteries

I63.30 Cerebral infarction due to thrombosis of unspecified cerebral artery

I63.31 Cerebral infarction due to thrombosis of middle cerebral artery

I63.32 Cerebral infarction due to thrombosis of anterior cerebral artery

I63.33 Cerebral infarction due to thrombosis of posterior cerebral artery

I63.34 Cerebral infarction due to thrombosis of cerebellar artery

I63.39 Cerebral infarction due to thrombosis of other cerebral artery

I63.4 Cerebral infarction due to embolism of cerebral arteries

• I63.40 Cerebral infarction due to embolism of unspecified cerebral artery
• I63.41 Cerebral infarction due to embolism of middle cerebral artery
• I63.42 Cerebral infarction due to embolism of anterior cerebral artery
• I63.43 Cerebral infarction due to embolism of posterior cerebral artery
• I63.44 Cerebral infarction due to embolism of cerebellar artery
• I63.49 Cerebral infarction due to embolism of other cerebral artery

I63.5 Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries

• I63.50 Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery
• I63.51 Cerebral infarction due to unspecified occlusion or stenosis of middle cerebral artery
• I63.52 Cerebral infarction due to unspecified occlusion or stenosis of anterior cerebral artery
• I63.53 Cerebral infarction due to unspecified occlusion or stenosis of posterior cerebral artery
• I63.54 Cerebral infarction due to unspecified occlusion or stenosis of cerebellar artery
• I63.59 Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery

I63.6 Cerebral infarction due to cerebral venous thrombosis, nonpyogenic

I63.8 Other cerebral infarction

• I63.81 …… due to occlusion or stenosis of small artery
• I63.89 Other cerebral infarction

I63.9 Cerebral infarction, unspecified

Identifying risk factors associated with the condition at an early stage, adopting a healthy lifestyle and following the physician’s recommendations correctly are the best ways to prevent a stroke. Common prevention strategies include – controlling high blood pressure and diabetes, quitting the usage of tobacco or alcohol, maintaining a healthy body weight, doing regular body exercise, and eating a diet rich in fruits and vegetables.

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