ICD-10 Coding for Left ICA Stenosis(I65.22)
Complete ICD-10-CM coding and documentation guide for Left ICA Stenosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Left ICA Stenosis
I65.2-I65.29Primary Range
Occlusion and stenosis of carotid artery
This range includes codes for stenosis and occlusion of carotid arteries, with specific codes for laterality.
Key Information: ICD-10 code for left ICA stenosis
Essential facts and insights about Left ICA Stenosis
Primary ICD-10-CM Code for left ica stenosis
Decision Criteria
clinical Criteria
- Imaging shows ≥50% stenosis in left ICA.
documentation Criteria
- Documentation specifies 'left internal carotid artery stenosis'.
Applicable To
- Left internal carotid artery stenosis
Excludes
- Cerebral infarction due to stenosis (I63.231)
Clinical Validation Requirements
- Imaging evidence of ≥50% stenosis
- Doppler ultrasound PSV ≥125 cm/s
Code-Specific Risks
- Incorrect laterality documentation
- Confusion with occlusion codes
Coding Notes
- Ensure laterality is clearly documented to avoid miscoding.
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.
Cerebral infarction due to left carotid stenosis
I63.231Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Left ICA Stenosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I65.22.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Always include imaging results in the patient's record., Use templates that prompt for specific details.
Impact
Reimbursement: Incorrect DRG assignment affecting payment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Verify documentation for laterality and use I65.22 for left-sided stenosis.
Impact
Failure to document laterality can lead to miscoding.
Mitigation Strategy
Implement mandatory fields in EHR for laterality.
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 Left ICA Stenosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Left ICA Stenosis
Use these documentation templates to ensure complete and accurate documentation for Left ICA Stenosis. These templates include all required elements for proper coding and billing.
Neurology Progress Note
Specialty: NeurologyRequired Elements
- Patient symptoms
- Imaging results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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