ICD-10 Coding for Carotid Artery Blockage(I65.21, I65.22)
Complete ICD-10-CM coding and documentation guide for Carotid Artery Blockage. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Carotid Artery Blockage
I65.2-I65.29Primary Range
Occlusion and stenosis of carotid artery
This range covers specific codes for stenosis and occlusion of the carotid artery, essential for accurate diagnosis and treatment coding.
Cerebral infarction due to carotid stenosis
These codes are used when a cerebral infarction is caused by carotid stenosis, requiring specific sequencing in documentation.
Disorder of arteries and arterioles, unspecified
Used when documentation lacks specificity, such as 'carotid artery disease' without further details.
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 without associated cerebral infarction. |
|
| I65.22 | Occlusion and stenosis of left carotid artery | Use when there is documented stenosis or occlusion of the left carotid artery without associated cerebral infarction. |
|
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 blockage
Essential facts and insights about Carotid Artery Blockage
Primary ICD-10-CM Codes for carotid artery blockage
Decision Criteria
clinical Criteria
- Documented stenosis of the right carotid artery with imaging confirmation.
Applicable To
- Right carotid artery stenosis
Excludes
- Cerebral infarction due to carotid stenosis (I63.2-)
Clinical Validation Requirements
- Doppler ultrasound showing >50% stenosis
- CT angiography confirming luminal narrowing
Code-Specific Risks
- Incorrectly coding without laterality
- Missing documentation of stenosis severity
Coding Notes
- Ensure laterality is documented and severity of stenosis is quantified.
I65.22 - Occlusion and stenosis of left carotid artery
Use when there is documented stenosis or occlusion of the left carotid artery without associated cerebral infarction.
Applicable To
- Left carotid artery stenosis
Excludes
- Cerebral infarction due to carotid stenosis (I63.2-)
Clinical Validation Requirements
- Doppler ultrasound showing >70% stenosis
- CT angiography confirming severe narrowing
Coding Notes
Ensure laterality and stenosis severity are documented.
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 Blockage 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 loss of reimbursement due to incorrect DRG assignment.
Mitigation Strategy
Ensure thorough documentation of clinical findings., Use specific language linking stenosis to stroke.
Impact
Reimbursement: May result in lower reimbursement due to lack of specificity., Compliance: Non-compliance with coding guidelines requiring specificity., Data Quality: Decreases data accuracy for clinical and research purposes.
Mitigation Strategy
Ensure documentation specifies stenosis or occlusion with laterality and severity.
Impact
Audits may target cases where stenosis is documented without laterality or severity.
Mitigation Strategy
Implement thorough documentation practices and regular training for providers.
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 Blockage, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Carotid Artery Blockage
Use these documentation templates to ensure complete and accurate documentation for Carotid Artery Blockage. These templates include all required elements for proper coding and billing.
Carotid Stenosis Evaluation
Specialty: NeurologyRequired Elements
- Symptoms
- Imaging results
- Causality
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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