ICD-10 Coding for Carotid Artery Disease(I65.21, I65.22)
Complete ICD-10-CM coding and documentation guide for Carotid Artery Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Carotid Artery Disease
I65.2-I65.29Primary Range
Occlusion and stenosis of carotid artery
This range covers specific codes for stenosis and occlusion of the carotid arteries, which are the primary manifestations of carotid artery disease.
Atherosclerosis of arteries
This range is used when atherosclerosis is the underlying cause of carotid artery disease.
Disorder of arteries and arterioles, unspecified
Used for unspecified arterial disorders when specific details are not documented.
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 there is documented stenosis or occlusion of the right carotid artery. |
|
| I65.22 | Occlusion and stenosis of left carotid artery | Use when there is documented stenosis or occlusion of the left carotid artery. |
|
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 carotid artery disease
Essential facts and insights about Carotid Artery Disease
Primary ICD-10-CM Codes for carotid artery disease
Decision Criteria
clinical Criteria
- Documented stenosis ≥50% on imaging
documentation Criteria
- Specify laterality and percentage of stenosis
Applicable To
- Right carotid artery stenosis
- Right carotid artery occlusion
Excludes
- Cerebral infarction due to carotid stenosis (I63.5-)
Clinical Validation Requirements
- Imaging showing ≥50% stenosis
- Symptoms of TIA or stroke
Code-Specific Risks
- Incorrect laterality documentation
- Missing imaging confirmation
Coding Notes
- Ensure laterality is documented and imaging supports the diagnosis.
I65.22 - Occlusion and stenosis of left carotid artery
Use when there is documented stenosis or occlusion of the left carotid artery.
Applicable To
- Left carotid artery stenosis
- Left carotid artery occlusion
Excludes
- Cerebral infarction due to carotid stenosis (I63.5-)
Clinical Validation Requirements
- Imaging showing ≥50% stenosis
- Symptoms of TIA or stroke
Coding Notes
Ensure laterality is documented and imaging supports the diagnosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Carotid Artery Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I65.21.
Impact
Clinical: Potential for incorrect treatment planning., Regulatory: Non-compliance with coding standards., Financial: Loss of reimbursement due to unspecified coding.
Mitigation Strategy
Always document laterality in clinical notes., Verify imaging reports include laterality.
Impact
Reimbursement: Potential underpayment due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data representation of patient condition.
Mitigation Strategy
Use I65.2- codes with specific laterality and stenosis details.
Impact
Using unspecified codes like I77.9 when specific codes apply.
Mitigation Strategy
Implement regular training on documentation specificity.
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 Carotid Artery Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Carotid Artery Disease
Use these documentation templates to ensure complete and accurate documentation for Carotid Artery Disease. These templates include all required elements for proper coding and billing.
Carotid stenosis with TIA
Specialty: NeurologyRequired Elements
- Patient demographics
- Symptoms and duration
- Imaging results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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