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ICD-10/I63.213

I63.213 ICD-10-CM Code: Cerebral infarction due to unspecified occlusion or stenosis of bilateral vertebral arteries

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 023 — CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR (MDC 01)
  • MS-DRG 024 — CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC (MDC 01)
  • MS-DRG 061 — ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC (MDC 01)
  • MS-DRG 062 — ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC (MDC 01)
  • MS-DRG 063 — ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC (MDC 01)
  • MS-DRG 064 — INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC (MDC 01)
  • MS-DRG 065 — INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS (MDC 01)
  • MS-DRG 066 — INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC (MDC 01)
  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 249 — Ischemic or Unspecified Stroke

Other models: CMS-HCC V22 HCC 100

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Official Registry Overview & Definition

Cerebral infarction due to unspecified occlusion or stenosis of bilateral vertebral arteries is a billable ICD-10-CM diagnosis code (I63.213).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for I63.213 in the official ICD-10-CM tabular list.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • occlusion and stenosis of cerebral and precerebral arteries, resulting in cerebral infarction

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code, if applicable, to identify status post administration of tPA (rtPA) in a different facility within the last 24 hours prior to admission to current facility (Z92.82)
  • Use additional code, if known, to indicate National Institutes of Health Stroke Scale (NIHSS) score (R29.7-)
  • Use additional code to identify presence of:
  • alcohol abuse and dependence (F10.-)
  • exposure to environmental tobacco smoke (Z77.22)
  • history of tobacco dependence (Z87.891)
  • hypertension (I10-I1A)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Cerebral infarction due to unspecified occlusion or stenosis of bilateral vertebral arteries
    FY2017 changes

Verify Before Coding

  • Billable — reportable as written.
  • MCC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Contextual Map

Every relationship of I63.213 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • I00-I99 — Chapter 9: Diseases of the Circulatory System (I00-I99) (I00-I99) [Hierarchy]
  • I60-I69 — Cerebrovascular diseases [Hierarchy]

Referenced by Excludes1 notes

  • I67 — Other cerebrovascular diseases [Excludes1](via I63.2.-): “Occlusion and stenosis of precerebral artery causing cerebral infarction (I63.2-)” · check together
  • P91.82 — Neonatal cerebral infarction [Excludes1](via I63.-): “cerebral infarction (I63.-)” · check together

Referenced by Code First instructions

  • R29.7 — National Institutes of Health Stroke Scale (NIHSS) score [Code First](via I63.-): “the type of cerebral infarction (I60.-, I61.-, I62.-, I63.-)” · check together
  • Z92.82 — Status post administration of tPA (rtPA) in a different facility within the last 24 hours prior to admission to current facility [Code First](via I63.-): “acute cerebral infarction (I63.-)” · check together

Referenced by Code Also instructions (11)

  • D57.03 — Hb-SS disease with cerebral vascular involvement [Code Also](via I63.-): “, if applicable, cerebral infarction (I63.-)” · check together
  • D57.213 — Sickle-cell/Hb-C disease with cerebral vascular involvement [Code Also](via I63.-): “, if applicable, cerebral infarction (I63.-)” · check together
  • D57.413 — Sickle-cell thalassemia, unspecified, with cerebral vascular involvement [Code Also](via I63.-): “, if applicable cerebral infarction (I63.-)” · check together
  • D57.433 — Sickle-cell thalassemia beta zero with cerebral vascular involvement [Code Also](via I63.-): “, if applicable cerebral infarction (I63.-)” · check together
  • D57.453 — Sickle-cell thalassemia beta plus with cerebral vascular involvement [Code Also](via I63.-): “, if applicable cerebral infarction (I63.-)” · check together
  • D57.813 — Other sickle-cell disorders with cerebral vascular involvement [Code Also](via I63.-): “, if applicable: cerebral infarction (I63.-)” · check together
  • D81.32 — Adenosine deaminase 2 deficiency [Code Also](via I63.-): “stroke (I63.-)” · check together
  • G43.6 — Persistent migraine aura with cerebral infarction [Code Also](via I63.-): “the type of cerebral infarction (I63.-)” · check together
  • and 3 more

Clinical classification (CCSR)

  • CIR020 — Cerebral infarction [CCSR]

Risk adjustment (CMS-HCC)

  • HCC 249 — Ischemic or Unspecified Stroke [CMS-HCC]

Potential MS-DRG (10)

  • MCC — Major Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (MCC).”
  • DRG 023 — CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR [MS-DRG]: “CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR (MDC 01)”
  • DRG 024 — CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC [MS-DRG]: “CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC (MDC 01)”
  • DRG 061 — ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC [MS-DRG]: “ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC (MDC 01)”
  • DRG 062 — ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC [MS-DRG]: “ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC (MDC 01)”
  • DRG 063 — ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC [MS-DRG]: “ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC (MDC 01)”
  • DRG 064 — INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC [MS-DRG]: “INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC (MDC 01)”
  • DRG 065 — INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS [MS-DRG]: “INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS (MDC 01)”
  • and 3 more

MDC crossing · procedures (8892)

  • MDC 01 — Diseases and Disorders of the Nervous System [MDC crossing]: “Diseases and Disorders of the Nervous System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 0016070 — Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach — grouped in MDC 01, the procedure side of this code's crossing.” · check together
  • 0016071 — Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach — grouped in MDC 01, the procedure side of this code's crossing.” · check together
  • 0016072 — Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach — grouped in MDC 01, the procedure side of this code's crossing.” · check together
  • 0016073 — Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach — grouped in MDC 01, the procedure side of this code's crossing.” · check together
  • 0016074 — Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach — grouped in MDC 01, the procedure side of this code's crossing.” · check together
  • and 8887 more

Nearest codes (40)

  • I63 — Cerebral infarction [Sibling]
  • I63.09 — Cerebral infarction due to thrombosis of other precerebral artery [Sibling]
  • I63.1 — Cerebral infarction due to embolism of precerebral arteries [Sibling]
  • I63.10 — Cerebral infarction due to embolism of unspecified precerebral artery [Sibling]
  • I63.11 — Cerebral infarction due to embolism of vertebral artery [Sibling]
  • I63.111 — Cerebral infarction due to embolism of right vertebral artery [Sibling]
  • I63.112 — Cerebral infarction due to embolism of left vertebral artery [Sibling]
  • I63.113 — Cerebral infarction due to embolism of bilateral vertebral arteries [Sibling]
  • and 32 more

Change history

  • FY2017 — Added to the code set [Change history]

Referenced by Other Codes

Clinical classification (AHRQ CCSR):CIR020 — Cerebral infarction (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Potential MS-DRG Relationships (FY2026)

MCC — Major Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 55 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 10 MS-DRGs: DRG 023 (MDC 01), DRG 024 (MDC 01), DRG 061 (MDC 01), DRG 062 (MDC 01), DRG 063 (MDC 01), DRG 064 (MDC 01), DRG 065 (MDC 01), DRG 066 (MDC 01), DRG 791 (MDC 15), DRG 793 (MDC 15).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Official ICD-10-CM tabular notes on other codes that name I63.213 or its code family.

2 Excludes1 notes across 2 chapters: I67 (via I63.2.-), P91.82 (via I63.-).

2 Code First instructions across 2 chapters: R29.7 (via I63.-), Z92.82 (via I63.-).

11 Code Also instructions across 3 chapters: D57.03 (via I63.-), D57.213 (via I63.-), D57.413 (via I63.-), D57.433 (via I63.-), D57.453 (via I63.-), D57.813 (via I63.-), D81.32 (via I63.-), G43.6 (via I63.-), G96.81 (via I63.-), I16.1 (via I63.-) and 1 more.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to I63.213 in its code family, with their registry titles.

  • I63.2 — Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries
  • I63.20 — Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries
  • I63.21 — Cerebral infarction due to unspecified occlusion or stenosis of vertebral arteries
  • I63.211 — Cerebral infarction due to unspecified occlusion or stenosis of right vertebral artery
  • I63.212 — Cerebral infarction due to unspecified occlusion or stenosis of left vertebral artery
  • I63.219 — Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral artery
  • I63.22 — Cerebral infarction due to unspecified occlusion or stenosis of basilar artery
  • I63.23 — Cerebral infarction due to unspecified occlusion or stenosis of carotid arteries
  • I63.231 — Cerebral infarction due to unspecified occlusion or stenosis of right carotid arteries
  • I63.232 — Cerebral infarction due to unspecified occlusion or stenosis of left carotid arteries

View all codes in the I63 family