G45.1 — Carotid artery syndrome (hemispheric)
G45.1 is a billable, specific ICD-10-CM code for carotid artery syndrome (hemispheric). It is valid for submission on a claim.
Risk adjustment
G45.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
G45.1 is named in 39 Medicare coverage policies — 39 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A52992Billing and Coding: Non-Invasive Cerebrovascular Arterial Studies
- A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
- A56476Billing and Coding: Cardiac Radionuclide Imaging
How G45.1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to G45.1.
- Insufficiency, insufficient›arterial›carotid(hemispheric)
- Syndrome›carotid›artery(hemispheric) (internal)
Related codes at this level
Codes that share G45. If G45.1 is not quite right, the correct code is usually one of these.
Questions about G45.1
- Is G45.1 a billable ICD-10-CM code?
- Yes. G45.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does G45.1 sit in the tabular list?
- Diseases of the nervous system (G00-G99), in the block Episodic and paroxysmal disorders (G40-G47).