I63.219
BillableCerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral 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 blockage or narrowing of a vertebral artery when it is unclear which side (left or right) is affected.
Coding Tips
- •Use this code only when laterality cannot be determined from documentation
- •Query provider if imaging or clinical notes suggest a specific side to allow for more precise coding
Clinical Significance
Cerebral infarction due to unspecified occlusion or stenosis of an unspecified vertebral artery is a posterior circulation stroke code where neither the mechanism nor the laterality of vertebral artery involvement is documented. This double-unspecified code represents a significant documentation improvement opportunity. It still captures the full stroke HCC weight but may draw audit scrutiny.
Documentation Requirements
- ✓Imaging confirmation of cerebral infarction in posterior circulation territory
- ✓Documentation of vertebral artery involvement as the cause
- ✓Documentation explaining why laterality and mechanism could not be determined
- ✓Neurological examination findings
- ✓Stroke workup results
- ✓Treatment and follow-up plan
Commonly Confused Codes
I63.211 — Unspecified occlusion of right vertebral artery; laterality specifiedI63.212 — Unspecified occlusion of left vertebral artery; laterality specifiedI63.011-I63.019 — Thrombosis of vertebral arteries; mechanism specifiedI63.111-I63.119 — Embolism of vertebral arteries; mechanism specifiedI63.20 — Unspecified occlusion of unspecified precerebral artery; does not even identify vertebral artery
Code Hierarchy
└I63Cerebral infarction└I63.2Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries└I63.21Cerebral infarction due to unspecified occlusion or stenosis of vertebral arteries└I63.219Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral artery
└I63.219Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral artery