ICD Code I65.23

ICD code I65.23 is used to identify the medical condition characterized by the narrowing or blockage of both carotid arteries, which are the major blood vessels in the neck that supply blood to the brain, neck, and face. This condition can lead to reduced blood flow to the brain and increase the risk of stroke.

1. Presence of Symptoms Indicative of Carotid Artery Disease: Patients may exhibit symptoms such as transient ischemic attacks (TIAs), which include sudden numbness or weakness in the face or limbs, particularly on one side of the body, difficulty speaking or understanding speech, sudden vision problems in one or both eyes, dizziness, or loss of balance and coordination.

2. Imaging Studies Confirming Bilateral Carotid Artery Occlusion or Stenosis: Diagnostic imaging such as Doppler ultrasound, magnetic resonance angiography (MRA), or computed tomography angiography (CTA) should confirm the presence of occlusion or significant stenosis in both carotid arteries.

3. History of Atherosclerosis or Risk Factors: The patient may have a history of atherosclerosis or risk factors such as hypertension, hyperlipidemia, diabetes, smoking, or a family history of cardiovascular disease, which could contribute to the development of carotid artery disease.

4. Clinical Evaluation by a Healthcare Provider: A thorough clinical evaluation by a healthcare provider, including a physical examination and review of the patient's medical history, should support the diagnosis of bilateral carotid artery occlusion or stenosis.

5. Exclusion of Other Causes: Other potential causes of the patient's symptoms should be ruled out to ensure that the symptoms are indeed due to carotid artery occlusion or stenosis.

6. Consideration of Surgical or Medical Intervention: The diagnosis may be used to determine the need for surgical intervention, such as carotid endarterectomy or stenting, or to guide medical management strategies to prevent stroke or other complications.

For the ICD code I65.23, which pertains to occlusion and stenosis of bilateral carotid arteries, the relevant CPT codes that may be applicable for treatment include:

1. 35301 - Thromboendarterectomy, with or without patch graft, carotid, vertebral, subclavian, by neck incision.

2. 37215 - Transcatheter placement of intravascular stent(s), cervical carotid artery, percutaneous; with distal embolic protection.

3. 37216 - Transcatheter placement of intravascular stent(s), cervical carotid artery, open; with distal embolic protection.

4. 0075T - Transcatheter placement of extracranial vertebral or intrathoracic carotid artery stent(s), including radiological supervision and interpretation; percutaneous, with distal embolic protection.

5. 0076T - Transcatheter placement of extracranial vertebral or intrathoracic carotid artery stent(s), including radiological supervision and interpretation; open, with distal embolic protection.

These CPT codes are typically used for procedures aimed at addressing the occlusion and stenosis of the carotid arteries. It is important for healthcare providers to verify the specific procedures and documentation requirements to ensure accurate coding and billing.

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