I63.531
BillableCerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral 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 blocked or narrowed artery on the right side of the brain that supplies the back portion of the brain.
Coding Tips
- •Ensure documentation clearly indicates right-sided posterior cerebral artery involvement before assigning this code.
- •This code requires documentation of laterality; if not specified, use I63.539 instead.
Clinical Significance
This code identifies an acute ischemic stroke due to occlusion or stenosis of the right posterior cerebral artery where the specific mechanism (thrombosis versus embolism) is not documented. The posterior cerebral artery supplies the occipital lobe, medial temporal lobe, and thalamus. Infarction in this territory affects vision and memory. 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 posterior cerebral artery
- ✓Documentation of laterality (right) 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 homonymous hemianopia, visual agnosia, memory deficits, and thalamic sensory loss)
- ✓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
I63.331 — Cerebral infarction due to thrombosis of right posterior cerebral artery; use when thrombosis is specifically documentedI63.431 — Cerebral infarction due to embolism of right posterior cerebral artery; 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└I63.53Cerebral infarction due to unspecified occlusion or stenosis of posterior cerebral artery└I63.531Cerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral artery
└I63.531Cerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral artery