I77.74
BillableDissection of vertebral artery
HCC Category Mapping
V24HCC 107 — Vascular Disease with Complications
0.450ESRDHCC 107 — Vascular Disease with Complications
0.000What This Code Means
A tear in the inner lining of the vertebral artery in the neck, which can reduce blood flow to the brain and potentially cause stroke.
Coding Tips
- •Specify laterality (right or left) when documented in the medical record
- •Distinguish from spontaneous dissection versus traumatic dissection if cause is documented
Clinical Significance
Dissection of the vertebral artery poses significant risk for posterior circulation stroke, as the vertebral arteries supply the brainstem and cerebellum. This condition may result from trauma (including cervical manipulation), spontaneous dissection, or connective tissue disorders. It requires urgent neurological evaluation and carries high resource utilization for monitoring and stroke prevention.
Documentation Requirements
- ✓Imaging confirmation of vertebral artery dissection (CT angiography, magnetic resonance angiography, or conventional angiography)
- ✓Laterality — right, left, or bilateral vertebral artery involvement
- ✓Etiology — spontaneous, traumatic, post-chiropractic manipulation, or connective tissue disorder
- ✓Neurological assessment including presence or absence of posterior circulation stroke symptoms
- ✓Treatment plan including anticoagulation versus antiplatelet therapy
- ✓Follow-up imaging timeline for monitoring
Excludes 2 — Not included here, may code separately
- aneurysm of vertebral artery (I72.6)
Commonly Confused Codes
I77.75 — Dissection of other precerebral arteries: for non-carotid, non-vertebral precerebral arteriesI77.71 — Dissection of carotid artery: anterior circulation vessel, not posteriorI65.0x — Occlusion and stenosis of vertebral artery: atherosclerotic narrowing, not dissectionI67.0 — Dissection of cerebral arteries: for intracranial arteries specifically
Code Hierarchy
└I77Other disorders of arteries and arterioles└I77.7Other arterial dissection└I77.74Dissection of vertebral artery
└I77.74Dissection of vertebral artery