As PDPM implementation gets underway, daily coding decisions often lead to questions. This new section of Proactive’s blog will address commonly asked questions. Click here to see all these PDPM Coding Questions blogs.

Q:

I am hearing other SLPs in the area stating they have been told that “cerebrovascular disease” can include Parkinson’s, dementia, etc. and to use these codes for these patients… Can you confirm/deny this for me? What does “other” and “unspecified” “cerebrovascular disease” mean? Can you provide me a list of what conditions are appropriate/included for use of these codes
I69.891
I69.991
I69.890
I69.92 -1-2-3-0-8

A:

I69 is only to be used to indicate conditions in I60-I67 as the cause of sequela. Which includes the following:
I60- Nontraumatic subarachnoid hemorrhage
I61- Nontraumatic intracerebral hemorrhage
I63 Cerebral infarction
I65- Occlusion & stenosis of precerebral arteries, not resulting in cerebral infarction
I67 Other cerebrovascular disease – which includes the following:

  • Dissection of cerebral arteries, nonruptured
  • Cerebral aneurysm, nonruptured
  • Cerebral atherosclerosis
  • Progressive vascular leukoencephalopathy
  • Hypertensive encephalopathy
  • Moyamoya disease
  • Nonpyogenic thrombosis of intracranial venous system
  • Cerebral arteritis, NEC
  • Acute cerebrovascular insufficiency
  • Cerebral ischemia
  • Posterior reversible encephalopathy syndrome
  • Cerebral vasospasm & vasoconstriction
  • Hereditary cerebrovascular disease
  • Unspecified cerebrovascular disease

As you can see, this does not include conditions such as Parkinsons & dementia (which are classified as diseases of nervous system, not cerebrovascular disease).

The “other” codes are listed above under I67” other cerebrovascular disease”. “Unspecified” would be used if the provider only lists the deficit as being related to cerebrovascular disease with no further specification of which type.

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Blog by Shelly Maffia, MSN, MBA, RN, LNHA, QCP, CHC, Director of Regulatory Services, Proactive Medical Review

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