ICD-10 Coding for Blocked Carotid Artery(I65.21, I65.22, I65.23, I63.2-)
Complete ICD-10-CM coding and documentation guide for Blocked Carotid Artery. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Blocked Carotid Artery
I65.2Primary Range
Occlusion and stenosis of carotid artery
This range covers the specific conditions of stenosis and occlusion of the carotid artery, which are the primary concerns in blocked carotid artery cases.
Cerebral infarction due to carotid stenosis
This range is relevant when a cerebral infarction is directly linked to carotid stenosis or occlusion.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I65.21 | Occlusion and stenosis of right carotid artery | Use when right carotid stenosis or occlusion is documented with imaging confirmation. |
|
| I65.22 | Occlusion and stenosis of left carotid artery | Use when left carotid stenosis or occlusion is documented with imaging confirmation. |
|
| I65.23 | Occlusion and stenosis of bilateral carotid arteries | Use when bilateral carotid stenosis or occlusion is documented with imaging confirmation. |
|
| I63.2- | Cerebral infarction due to carotid stenosis | Use when a cerebral infarction is directly linked to carotid stenosis. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for blocked carotid artery
Essential facts and insights about Blocked Carotid Artery
Primary ICD-10-CM Codes for blocked carotid artery
Decision Criteria
clinical Criteria
- Presence of >50% stenosis on imaging
documentation Criteria
- Explicit mention of right carotid stenosis or occlusion
Applicable To
- Right carotid artery stenosis
- Right carotid artery occlusion
Excludes
- Cerebral infarction due to carotid stenosis (I63.2-)
Clinical Validation Requirements
- Imaging evidence of >50% stenosis
- Doppler ultrasound or CTA confirmation
Code-Specific Risks
- Incorrect laterality documentation
- Missing imaging confirmation
Coding Notes
- Ensure laterality is clearly documented to avoid unspecified coding.
I65.22 - Occlusion and stenosis of left carotid artery
Use when left carotid stenosis or occlusion is documented with imaging confirmation.
Applicable To
- Left carotid artery stenosis
- Left carotid artery occlusion
Excludes
- Cerebral infarction due to carotid stenosis (I63.2-)
Clinical Validation Requirements
- Imaging evidence of >50% stenosis
- Doppler ultrasound or CTA confirmation
Coding Notes
Ensure laterality is clearly documented to avoid unspecified coding.
I65.23 - Occlusion and stenosis of bilateral carotid arteries
Use when bilateral carotid stenosis or occlusion is documented with imaging confirmation.
Applicable To
- Bilateral carotid artery stenosis
- Bilateral carotid artery occlusion
Excludes
- Cerebral infarction due to carotid stenosis (I63.2-)
Clinical Validation Requirements
- Imaging evidence of >50% stenosis on both sides
- Doppler ultrasound or CTA confirmation
Coding Notes
Ensure bilateral involvement is clearly documented to avoid unspecified coding.
I63.2- - Cerebral infarction due to carotid stenosis
Use when a cerebral infarction is directly linked to carotid stenosis.
Applicable To
- Stroke due to carotid stenosis
Clinical Validation Requirements
- Imaging evidence of infarction in territory supplied by stenosed carotid artery
- Absence of cardioembolic source
Coding Notes
Ensure the infarction is causally linked to carotid stenosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Atherosclerosis of other arteries
I70.8Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Blocked Carotid Artery to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I65.21.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Always include laterality in notes., Use templates that prompt for laterality.
Impact
Reimbursement: May lead to denied claims or lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of patient condition.
Mitigation Strategy
Always code I65.2- if stenosis or occlusion is confirmed.
Impact
Failure to document laterality can lead to unspecified coding.
Mitigation Strategy
Implement mandatory fields for laterality in EHR templates.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Blocked Carotid Artery, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Blocked Carotid Artery
Use these documentation templates to ensure complete and accurate documentation for Blocked Carotid Artery. These templates include all required elements for proper coding and billing.
Symptomatic carotid stenosis
Specialty: NeurologyRequired Elements
- Patient symptoms
- Imaging results
- Laterality
- Severity of stenosis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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