ICD-10-CM Code Z86.73

Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits

Version 2020 Billable Code Unacceptable Principal Diagnosis POA Exempt

Valid for Submission

Z86.73 is a billable code used to specify a medical diagnosis of personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z86.73 might also be used to specify conditions or terms like h/o: embolism, h/o: embolism, h/o: stroke in last year, h/o: tia, history of artery embolism, history of artery embolism, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z86.73 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.

ICD-10:Z86.73
Short Description:Prsnl hx of TIA (TIA), and cereb infrc w/o resid deficits
Long Description:Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code Z86.73:

Inclusion Terms

Inclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
  • Personal history of prolonged reversible ischemic neurological deficit (PRIND)
  • Personal history of stroke NOS without residual deficits

Type 1 Excludes

Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
  • personal history of traumatic brain injury Z87.820
  • sequelae of cerebrovascular disease I69

Index to Diseases and Injuries

The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Z86.73 are found in the index:


Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:

  • Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual’s health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • H/O: embolism
  • H/O: embolism
  • H/O: Stroke in last year
  • H/O: TIA
  • History of artery embolism
  • History of artery embolism
  • History of cardioembolic stroke
  • History of cerebellar stroke
  • History of cerebrovascular accident
  • History of cerebrovascular accident greater than eight weeks in the past
  • History of cerebrovascular accident in last eight weeks
  • History of cerebrovascular accident with residual deficit
  • History of cerebrovascular accident without residual deficits
  • History of embolic stroke without deficits
  • History of embolic stroke without residual deficits
  • History of hemorrhagic cerebrovascular accident without residual deficits
  • History of ischemic stroke without residual deficits
  • History of lacunar cerebrovascular accident
  • History of parietal cerebrovascular accident
  • History of peripheral vascular disease
  • History of peripheral vascular disease
  • History of thrombotic stroke without residual deficits
  • History of transient ischemic attack due to embolism

Present on Admission (POA)

Z86.73 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here .

CMS POA Indicator Options and Definitions
POA Indicator CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Convert Z86.73 to ICD-9

  • V12.54 - Hx TIA/stroke w/o resid

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)
      • Personal history of certain other diseases (Z86)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020

Information for Patients


Stroke

What is a stroke?

A stroke happens when there is a loss of blood flow to part of the brain. Your brain cells cannot get the oxygen and nutrients they need from blood, and they start to die within a few minutes. This can cause lasting brain damage, long-term disability, or even death.

If you think that you or someone else is having a stroke, call 911 right away. Immediate treatment may save someone's life and increase the chances for successful rehabilitation and recovery.

What are the types of stroke?

There are two types of stroke:

  • Ischemic stroke is caused by a blood clot that blocks or plugs a blood vessel in the brain. This is the most common type; about 80 percent of strokes are ischemic.
  • Hemorrhagic stroke is caused by a blood vessel that breaks and bleeds into the brain

Another condition that's similar to a stroke is a transient ischemic attack (TIA). It's sometimes called a "mini-stroke." TIAs happen when the blood supply to the brain is blocked for a short time. The damage to the brain cells isn't permanent, but if you have had a TIA, you are at a much higher risk of having a stroke.

Who is at risk for a stroke?

Certain factors can raise your risk of a stroke. The major risk factors include

  • High blood pressure. This is the primary risk factor for a stroke.
  • Diabetes.
  • Heart diseases. Atrial fibrillation and other heart diseases can cause blood clots that lead to stroke.
  • Smoking. When you smoke, you damage your blood vessels and raise your blood pressure.
  • A personal or family history of stroke or TIA.
  • Age. Your risk of stroke increases as you get older.
  • Race and ethnicity. African Americans have a higher risk of stroke.

There are also other factors that are linked to a higher risk of stroke, such as

  • Alcohol and illegal drug use
  • Not getting enough physical activity
  • High cholesterol
  • Unhealthy diet
  • Having obesity

What are the symptoms of stroke?

The symptoms of stroke often happen quickly. They include

  • Sudden numbness or weakness of the face, arm, or leg (especially on one side of the body)
  • Sudden confusion, trouble speaking, or understanding speech
  • Sudden trouble seeing in one or both eyes
  • Sudden difficulty walking, dizziness, loss of balance or coordination
  • Sudden severe headache with no known cause

If you think that you or someone else is having a stroke, call 911 right away.

How are strokes diagnosed?

To make a diagnosis, your health care provider will

  • Ask about your symptoms and medical history
  • Do a physical exam, including a check of
    • Your mental alertness
    • Your coordination and balance
    • Any numbness or weakness in your face, arms, and legs
    • Any trouble speaking and seeing clearly
  • Run some tests, which may include
    • Diagnostic imaging of the brain, such as a CT scan or MRI
    • Heart tests, which can help detect heart problems or blood clots that may have led to a stroke. Possible tests include an electrocardiogram (EKG) and an echocardiography.

What are the treatments for stroke?

Treatments for stroke include medicines, surgery, and rehabilitation. Which treatments you get depend on the type of stroke and the stage of treatment. The different stages are

  • Acute treatment, to try to stop a stroke while it is happening
  • Post-stroke rehabilitation, to overcome the disabilities caused by the stroke
  • Prevention, to prevent a first stroke or, if you have already had one, prevent another stroke

Acute treatments for ischemic stroke are usually medicines:

  • You may get tPA, (tissue plasminogen activator), a medicine to dissolve the blood clot. You can only get this medicine within 4 hours of when your symptoms started. The sooner you can get it, the better your chance of recovery.
  • If you cannot get that medicine, you may get medicine that helps stop platelets from clumping together to form blood clots. Or you may get a blood thinner to keep existing clots from getting bigger.
  • If you have carotid artery disease, you may also need a procedure to open your blocked carotid artery

Acute treatments for hemorrhagic stroke focus on stopping the bleeding. The first step is to find the cause of bleeding in the brain. The next step is to control it:

  • If high blood pressure is the cause of bleeding, you may be given blood pressure medicines.
  • If an aneurysm if the cause, you may need aneurysm clipping or coil embolization. These are surgeries to prevent further leaking of blood from the aneurysm. It also can help prevent the aneurysm from bursting again.
  • If an arteriovenous malformation (AVM) is the cause of a stroke, you may need an AVM repair. An AVM is a tangle of faulty arteries and veins that can rupture within the brain. An AVM repair may be done through
    • Surgery
    • Injecting a substance into the blood vessels of the AVM to block blood flow
    • Radiation to shrink the blood vessels of the AVM

Stroke rehabilitation can help you relearn skills you lost because of the damage. The goal is to help you become as independent as possible and to have the best possible quality of life.

Prevention of another stroke is also important, since having a stroke increases the risk of getting another one. Prevention may include heart-healthy lifestyle changes and medicines.

Can strokes be prevented?

If you have already had a stroke or are at risk of having a stroke, you can make some heart-healthy lifestyle changes to try to prevent a future stroke:

  • Eating a heart-healthy diet
  • Aiming for a healthy weight
  • Managing stress
  • Getting regular physical activity
  • Quitting smoking
  • Managing your blood pressure and cholesterol levels

If these changes aren't enough, you may need medicine to control your risk factors.

NIH: National Institute of Neurological Disorders and Stroke


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Transient Ischemic Attack

A transient ischemic attack (TIA) is a stroke that lasts only a few minutes. It happens when the blood supply to part of the brain is briefly blocked. Symptoms of a TIA are like other stroke symptoms, but do not last as long. They happen suddenly, and include

  • Numbness or weakness, especially on one side of the body
  • Confusion or trouble speaking or understanding speech
  • Trouble seeing in one or both eyes
  • Difficulty walking
  • Dizziness
  • Loss of balance or coordination

Most symptoms of a TIA disappear within an hour, although they may last for up to 24 hours. Because you cannot tell if these symptoms are from a TIA or a stroke, you should go to the hospital right away.

TIAs are often a warning sign for future strokes. Taking medicine, such as blood thinners, may reduce your risk of a stroke. Your doctor might also recommend surgery. You can also help lower your risk by having a healthy lifestyle. This includes not smoking, not drinking too much, eating a healthy diet, and exercising. It is also important to control other health problems, such as high blood pressure and cholesterol.

NIH: National Institute of Neurological Disorders and Stroke


[Learn More]