I63.239
BillableCerebral infarction due to unspecified occlusion or stenosis of unspecified carotid 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 carotid artery when it is unclear which side is affected.
Coding Tips
- •Use only when laterality is truly unspecified in the medical record
- •Attempt to clarify with provider or imaging reports before defaulting to this unspecified code
Clinical Significance
Cerebral infarction due to unspecified occlusion or stenosis of an unspecified carotid artery is a highly nonspecific stroke code where neither the mechanism nor the laterality of carotid involvement is documented. This represents the lowest specificity level for carotid territory strokes and is a significant documentation improvement target. It still captures the full HCC weight but is likely to be flagged in audits.
Documentation Requirements
- ✓Imaging confirmation of acute cerebral infarction
- ✓Documentation of carotid artery involvement as the stroke cause
- ✓Documentation explaining why laterality and mechanism are both undetermined
- ✓Neurological examination findings
- ✓Stroke workup results
- ✓Treatment and follow-up plan
Commonly Confused Codes
I63.231 — Right carotid artery occlusion; laterality specifiedI63.232 — Left carotid artery occlusion; laterality specifiedI63.031-I63.039 — Carotid artery thrombosis codes; mechanism specifiedI63.131-I63.139 — Carotid artery embolism codes; mechanism specifiedI63.20 — Unspecified precerebral artery occlusion; does not identify carotid
Code Hierarchy
└I63Cerebral infarction└I63.2Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries└I63.23Cerebral infarction due to unspecified occlusion or stenosis of carotid arteries└I63.239Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid artery
└I63.239Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid artery