ICD-10 Coding for Carotid Atherosclerosis(I65.21, I70.92)
Complete ICD-10-CM coding and documentation guide for Carotid Atherosclerosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Carotid Atherosclerosis
I65.21-I65.29Primary Range
Occlusion and stenosis of carotid artery
Primary range for coding carotid stenosis due to atherosclerosis.
Atherosclerosis of other arteries
Used when atherosclerosis is the underlying cause of carotid stenosis.
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 is confirmed by imaging. |
|
| I70.92 | Atherosclerosis of other arteries | Use when atherosclerosis is documented as the cause of 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 carotid atherosclerosis
Essential facts and insights about Carotid Atherosclerosis
Primary ICD-10-CM Codes for carotid atherosclerosis
Decision Criteria
clinical Criteria
- Imaging confirms ≥50% stenosis
documentation Criteria
- Documentation specifies right carotid artery
Applicable To
- Right carotid artery stenosis
Excludes
- Cerebral infarction (I63.2-)
Clinical Validation Requirements
- Imaging showing ≥50% stenosis
- Symptoms correlating with stenosis
Code-Specific Risks
- Incorrectly coding without imaging confirmation
Coding Notes
- Ensure documentation specifies laterality and cause.
I70.92 - Atherosclerosis of other arteries
Use when atherosclerosis is documented as the cause of stenosis.
Applicable To
- Atherosclerosis of carotid artery
Excludes
- Atherosclerosis of coronary arteries (I25.-)
Clinical Validation Requirements
- Imaging showing plaque presence
- Clinical correlation with symptoms
Coding Notes
Ensure atherosclerosis is documented as the cause.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Carotid Atherosclerosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I65.21.
Impact
Clinical: Inaccurate clinical representation, Regulatory: Non-compliance with coding standards, Financial: Potential for reduced reimbursement
Mitigation Strategy
Educate providers on documentation specificity, Implement documentation checklists
Impact
Reimbursement: Lower reimbursement due to non-specific coding, Compliance: Potential compliance issues with coding guidelines, Data Quality: Decreased data quality and accuracy
Mitigation Strategy
Query provider for specificity if documentation is unclear.
Impact
Risk of audits due to non-specific coding of carotid conditions.
Mitigation Strategy
Ensure detailed documentation and use of specific codes.
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 Atherosclerosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Carotid Atherosclerosis
Use these documentation templates to ensure complete and accurate documentation for Carotid Atherosclerosis. These templates include all required elements for proper coding and billing.
Carotid atherosclerosis with stenosis
Specialty: NeurologyRequired Elements
- Stenosis percentage
- Laterality
- Atherosclerosis confirmation
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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