I63.523
BillableCerebral infarction due to unspecified occlusion or stenosis of bilateral anterior cerebral arteries
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 narrowing or blockage affecting both the right and left anterior cerebral arteries simultaneously.
Coding Tips
- •Verify bilateral anterior cerebral artery involvement is clearly documented
- •This rare presentation may result in significant cognitive and motor deficits affecting both lower extremities
Clinical Significance
This code identifies an acute ischemic stroke due to occlusion or stenosis of the bilateral anterior cerebral artery where the specific mechanism (thrombosis versus embolism) is not documented. 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
- ✓If the mechanism (thrombosis vs. embolism) can be determined from imaging or clinical workup, a more specific code should be assigned
- ✓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
I63.323 — Cerebral infarction due to thrombosis of bilateral anterior cerebral arteries; use when thrombosis is specifically documentedI63.423 — Cerebral infarction due to embolism of bilateral anterior cerebral arteries; use when embolism is specifically documentedI69.3xx — Sequelae of cerebral infarction; use for residual deficits from a prior stroke during follow-up visits, not during the acute eventG45.9 — Transient cerebral ischemic attack, unspecified; use when symptoms resolve completely within 24 hours with no evidence of infarction on imaging
Code Hierarchy
└I63Cerebral infarction└I63.5Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries└I63.52Cerebral infarction due to unspecified occlusion or stenosis of anterior cerebral artery└I63.523Cerebral infarction due to unspecified occlusion or stenosis of bilateral anterior cerebral arteries
└I63.523Cerebral infarction due to unspecified occlusion or stenosis of bilateral anterior cerebral arteries