Find information on intracranial aneurysm diagnosis, including clinical documentation, medical coding, and healthcare resources. Learn about subarachnoid hemorrhage, cerebral angiography, diagnostic imaging, ICD-10 codes (I67.1), and treatment options for brain aneurysms. This resource provides essential information for healthcare professionals, coders, and patients seeking to understand intracranial aneurysms. Explore symptoms, risk factors, and the importance of accurate clinical documentation for effective management of this serious condition.
Also known as
Intracranial aneurysm
Weakness in a cerebral artery wall forms a bulge.
Cerebrovascular diseases
Conditions affecting blood vessels supplying the brain.
Other cerebrovascular diseases
Cerebrovascular disorders not classified elsewhere.
Vertebro-basilar artery syndrome
Reduced blood flow in posterior circulation of the brain.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the aneurysm ruptured?
Yes
Location of rupture specified?
No
Is the aneurysm causing symptoms?
When to use each related code
| Description |
|---|
| Intracranial Aneurysm |
| Subarachnoid Hemorrhage |
| Cerebral Arteriovenous Malformation |
Miscoding unruptured (I77.21) vs. ruptured (I60.x) aneurysms based on documentation.
Lack of documentation specifying aneurysm location impacts code selection (e.g., I77.211, I77.212).
Missing size information prevents accurate coding for large or giant aneurysms affecting reimbursement.
Q: What are the most sensitive and specific diagnostic imaging modalities for detecting and characterizing intracranial aneurysms in a suspected SAH patient?
A: In suspected subarachnoid hemorrhage (SAH) patients, the gold standard for detecting and characterizing intracranial aneurysms (IAs) remains digital subtraction angiography (DSA). However, non-invasive techniques like computed tomography angiography (CTA) offer high sensitivity (approaching 95-100% for aneurysms > 5mm) and specificity, often serving as the initial diagnostic test due to its speed and availability. Magnetic resonance angiography (MRA) can also be helpful, particularly Time-of-Flight MRA (TOF-MRA) for visualizing flow-related enhancements, but its sensitivity can be slightly lower than CTA for smaller aneurysms. For patients with negative initial CTA and persistent clinical suspicion of SAH, DSA is still warranted. Explore how a combined CTA/MRA approach can enhance diagnostic accuracy in challenging cases.
Q: How do I differentiate between a ruptured intracranial aneurysm and other causes of sudden severe headache in the emergency department?
A: Differentiating a ruptured intracranial aneurysm (IA) from other causes of sudden severe headache, such as migraine, cluster headache, or even meningitis, requires careful clinical evaluation. Key features suggestive of a ruptured IA include a sudden onset of the "worst headache of my life," accompanied by signs of meningeal irritation (e.g., nuchal rigidity, photophobia), altered mental status, or focal neurological deficits. While a non-contrast head CT is essential for detecting subarachnoid hemorrhage (SAH), it can be negative in a small percentage of cases. If clinical suspicion remains high despite a negative initial CT, consider performing a lumbar puncture to assess for xanthochromia, a key indicator of SAH. Learn more about the role of early brain imaging and lumbar puncture in evaluating suspected IA rupture.
Patient presents with complaints concerning possible intracranial aneurysm, including sudden onset severe headache described as the "worst headache of their life", nausea, vomiting, stiff neck, photophobia, and blurred vision. Differential diagnosis includes migraine, meningitis, subarachnoid hemorrhage, and transient ischemic attack. Neurological examination reveals possible cranial nerve deficits, altered mental status, and nuchal rigidity. Initial imaging with computed tomography angiography (CTA) of the head is ordered to evaluate for the presence, size, location, and morphology of a suspected cerebral aneurysm. If CTA is positive or inconclusive, further evaluation with magnetic resonance angiography (MRA) or digital subtraction angiography (DSA) may be indicated. Risk factors for intracranial aneurysm development, including family history, smoking, hypertension, and age, were assessed. Patient's current medications, allergies, and past medical history were reviewed. Preliminary diagnosis of suspected intracranial aneurysm is made pending imaging results. Treatment options, including surgical clipping, endovascular coiling, flow diversion, and conservative management with blood pressure control and close monitoring, will be discussed with the patient upon confirmation of diagnosis. Patient education provided on symptoms of aneurysm rupture, including sudden severe headache, loss of consciousness, and seizures, and instructed to return to the emergency department immediately if these occur. ICD-10 code I77.1 (Intracranial aneurysm, unspecified) assigned, pending definitive diagnosis. CPT codes for diagnostic imaging and subsequent interventions will be documented following completion of procedures.