I63.81: Other cerebral infarction due to occlusion or stenosis of small artery
I63.81 is a billable, specific ICD-10-CM code for other cerebral infarction due to occlusion or stenosis of small artery. It is valid for submission on a claim.
Check I63.81 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Lacunar infarction
Excludes1 inherited from the categories above I63.81
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above I63.81
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with I63.81
Their own Excludes1 notes name this code, so the conflict is not listed above.
- P91.82Neonatal cerebral infarction
Risk adjustment
I63.81 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 249 Ischemic or Unspecified Stroke0.239 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
I63.81 is named in 41 Medicare coverage policies: 41 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52868Billing and Coding: Transesophageal Echocardiography (TEE)
- A52992Billing and Coding: Non-Invasive Cerebrovascular Arterial Studies
- A53057Billing and Coding: Home Health Occupational Therapy
- A53064Billing and Coding: Outpatient Occupational Therapy
Alphabetic index entries that lead here
- Infarct, infarction›lacunar
- Infarct, infarction›cerebral›due to›occlusion NEC›small artery
- Infarct, infarction›cerebral›due to›stenosis NEC›small artery
Code history
Unchanged in every release from FY2024 to FY2027.