I63.323

Billable

Cerebral infarction due to thrombosis of bilateral anterior cerebral arteries

HCC Category Mapping

V28HCC 249 — Ischemic or Unspecified Stroke

0.289

V24HCC 100 — Ischemic or Unspecified Stroke

0.262

ESRDHCC 100 — Ischemic or Unspecified Stroke

0.000

What This Code Means

A stroke caused by blood clots blocking both the right and left anterior cerebral arteries simultaneously, affecting the front portions of both sides of the brain.

Coding Tips

•Bilateral coding requires explicit documentation that both anterior cerebral arteries are affected
•This presentation is uncommon; ensure documentation clearly supports bilateral involvement

Clinical Significance

This code identifies an acute ischemic stroke caused by thrombosis (in-situ clot formation) of the bilateral anterior cerebral artery, requiring precise documentation of the clot mechanism. The anterior cerebral artery supplies the medial surfaces of the frontal and parietal lobes, including the motor and sensory cortex for the lower extremity. Accurate coding of the mechanism, artery, and laterality is critical for risk adjustment and tracking stroke subtypes for quality measures and secondary prevention strategies.

Documentation Requirements

✓Provider documentation of acute cerebral infarction (stroke) as a confirmed diagnosis, not rule-out or suspected
✓Identification of the affected artery as the anterior cerebral artery
✓Documentation of laterality (bilateral) supported by clinical findings and/or imaging
✓Documentation that thrombosis (in-situ clot formation) is the underlying mechanism, typically supported by vascular imaging such as computed tomography angiography or magnetic resonance angiography
✓Neurological examination findings consistent with the identified vascular territory (e.g., contralateral leg weakness greater than arm weakness, personality changes, urinary incontinence, and abulia)
✓Brain imaging (computed tomography or magnetic resonance imaging) confirming acute infarction
✓Timing of symptom onset to confirm acute presentation
✓Documentation of stroke severity (National Institutes of Health Stroke Scale score preferred)
✓Treatment administered (thrombolytics, thrombectomy, antiplatelet therapy, anticoagulation)

Commonly Confused Codes

I63.423 — Cerebral infarction due to embolism of bilateral anterior cerebral arteries; use for embolic rather than thrombotic mechanism I69.3xx — Sequelae of cerebral infarction; use for residual deficits from a prior stroke during follow-up visits, not during the acute event G45.9 — Transient cerebral ischemic attack, unspecified; use when symptoms resolve completely within 24 hours with no evidence of infarction on imaging

Code Hierarchy

└I63Cerebral infarction └I63.3Cerebral infarction due to thrombosis of cerebral arteries └I63.32Cerebral infarction due to thrombosis of anterior cerebral artery └I63.323Cerebral infarction due to thrombosis of bilateral anterior cerebral arteries

└I63.323Cerebral infarction due to thrombosis of bilateral anterior cerebral arteries