I63.239: Cereb infrc due to unsp occls or stenos of unsp crtd artery
Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid artery
Quick Clinical & Billing Summary
What is ICD-10-CM code I63.239? I63.239 represents Cereb infrc due to unsp occls or stenos of unsp crtd artery. Under official CDC guidelines, this code is billable and specific for claim submission.
Code Hierarchy & Classification
Clinical Guidance & Documentation Standards
CMS-HCC Risk Adjustment Model
Diagnoses under category I63 map to the official CMS-HCC (Hierarchical Condition Category) risk adjustment model used for Medicare Advantage risk scoring.
Associated Procedures & Medicare RVU Reimbursement
Open RVU Calculator →Typical outpatient and office evaluation procedures frequently billed alongside diagnosis I63.239:
| CPT/HCPCS | Description | Work RVU | Non-Facility Fee | Facility Fee |
|---|---|---|---|---|
| 99213 | Office/outpatient visit, established patient, 20-29 minutes (Low MDM) | 1.30 | $91.69 | $66.79 |
| 99214 | Office/outpatient visit, established patient, 30-39 minutes (Moderate MDM) | 1.92 | $133.61 | $100.21 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection (subcutaneous/intramuscular) | 0.17 | $18.34 | $12.44 |
CPT Modifier & Billing Rules
Append when a significant, separately identifiable evaluation and management service is provided on the same calendar day as a minor surgical procedure or injection.
Identifies procedures or services not normally reported together but distinct under the clinical circumstances. Use CMS X-modifiers (XE, XS, XP, XU) where required by Medicare.
Frequently Asked Questions about I63.239
Is I63.239 a billable ICD-10 code?
Yes, I63.239 is a valid, billable and specific ICD-10-CM code. It can be reported as a primary or secondary diagnosis on medical claims.
What is the ICD-10 code for Cereb infrc due to unsp occls or stenos of unsp crtd artery?
The primary ICD-10-CM code for Cereb infrc due to unsp occls or stenos of unsp crtd artery is I63.239.
What is the effective date of the current I63.239 code?
The code is active for fiscal year FY2027, effective starting 2026-10-01.
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