I63.00
BillableCerebral infarction due to thrombosis of unspecified precerebral artery
HCC Category Mapping
V28HCC 249 — Ischemic or Unspecified Stroke
0.289V24HCC 100 — Ischemic or Unspecified Stroke
0.262ESRDHCC 100 — Ischemic or Unspecified Stroke
0.000What This Code Means
A stroke caused by a blood clot in an artery leading to the brain, but the specific artery is not identified.
Coding Tips
- •Use this code only when the specific precerebral artery cannot be determined from documentation
- •Review imaging reports and physician notes to identify the specific artery involved for more precise coding
Clinical Significance
Cerebral infarction due to thrombosis of an unspecified precerebral artery represents an ischemic stroke caused by a blood clot forming in one of the arteries supplying the brain (vertebral, basilar, carotid, or other), but the specific artery is not identified. This is a major acute cerebrovascular event that significantly impacts patient outcomes and healthcare resource utilization. Accurate capture is critical for risk adjustment in Medicare Advantage populations.
Documentation Requirements
- ✓Documentation of acute cerebral infarction confirmed by imaging (CT or MRI)
- ✓Identification of thrombosis as the mechanism of stroke
- ✓Documentation that the affected precerebral artery could not be determined
- ✓Neurological examination including National Institutes of Health Stroke Scale score
- ✓Time of symptom onset and treatment decisions (thrombolytics, thrombectomy)
- ✓Risk factor assessment including hypertension, diabetes, hyperlipidemia, and smoking
Commonly Confused Codes
I63.01x — Thrombosis of vertebral artery; use when vertebral artery is identifiedI63.02 — Thrombosis of basilar artery; use when basilar artery is identifiedI63.03x — Thrombosis of carotid artery; use when carotid artery is identifiedI63.10 — Embolism of unspecified precerebral artery; different mechanism (embolism vs. thrombosis)I63.9 — Cerebral infarction, unspecified; even less specific, does not identify mechanism