ICD-9 Code 438.13

Late effects of cerebrovascular disease, dysarthria

Not Valid for Submission

438.13 is a legacy non-billable code used to specify a medical diagnosis of late effects of cerebrovascular disease, dysarthria. This code was replaced on September 30, 2015 by its ICD-10 equivalent.

ICD-9: 438.13
Short Description:Late eff CV-dysarthria
Long Description:Late effects of cerebrovascular disease, dysarthria

Convert 438.13 to ICD-10

The following crosswalk between ICD-9 to ICD-10 is based based on the General Equivalence Mappings (GEMS) information:

  • I69.922 - Dysarthria following unspecified cerebrovascular disease

Code Classification

  • Diseases of the circulatory system (390–459)
    • Cerebrovascular disease (430-438)
      • 438 Late effects of cerebrovascular disease

Information for Medical Professionals

Index to Diseases and Injuries

References found for the code 438.13 in the Index of Diseases and Injuries:


Information for Patients


Speech and Communication Disorders

Many disorders can affect our ability to speak and communicate. They range from saying sounds incorrectly to being completely unable to speak or understand speech. Causes include:

  • Hearing disorders and deafness
  • Voice problems, such as dysphonia or those caused by cleft lip or palate
  • Speech problems like stuttering
  • Developmental disabilities
  • Learning disabilities
  • Autism spectrum disorder
  • Brain injury
  • Stroke

Some speech and communication problems may be genetic. Often, no one knows the causes. By first grade, about 5% of children have noticeable speech disorders. Speech and language therapy can help.

NIH: National Institute on Deafness and Other Communication Disorders


[Read More]

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% 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


[Read More]

ICD-9 Footnotes

General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.

  • Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
  • No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
  • Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.

Index of Diseases and Injuries Definitions

  • And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
  • Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
  • Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
  • Type 1 Excludes Notes - 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.
  • Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
  • Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
  • Inclusion terms - List of terms is included under some codes. 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.
  • NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
  • NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
  • See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
  • See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
  • 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
  • With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.