What is the ICD (International Classification of Diseases) code for an intracerebral hypertensive hemorrhage with intraventricular extension?

ICD-10 Code for Intracerebral Hypertensive Hemorrhage with Intraventricular Extension

The appropriate ICD-10 code for intracerebral hypertensive hemorrhage with intraventricular extension is I61.5 (Intracerebral hemorrhage in cerebrum, intraventricular).

Coding Rationale and Classification

The coding for this condition follows a specific hierarchy in the ICD-10 classification system:

• I61 represents the category for intracerebral hemorrhage
• I61.5 specifically denotes intracerebral hemorrhage with intraventricular extension

This code is most appropriate because:

1. The primary pathology is an intracerebral hemorrhage
2. The hemorrhage has extended into the ventricular system
3. The hypertensive etiology is included within this code as hypertension is the most common cause of spontaneous intracerebral hemorrhage 1

Clinical Significance of Intraventricular Extension

Intraventricular hemorrhage (IVH) occurs in approximately 45% of patients with spontaneous intracerebral hemorrhage 1. This extension significantly worsens prognosis:

• Increases mortality from 20% to 51% 1
• Often leads to hydrocephalus in approximately half of affected patients 1
• Associated with worse functional outcomes as measured by the modified Graeb Scale 2

Management Implications of This Diagnosis

The ICD code I61.5 identifies a condition that typically requires:

• Admission to a neuroscience intensive care unit 3
• Consideration for external ventricular drainage (EVD) in patients with decreased level of consciousness 1
• Possible intracranial pressure monitoring in patients with GCS ≤8 1
• Evaluation for potential surgical intervention if there is significant mass effect 1

Documentation Requirements

When documenting this condition to support the I61.5 code, clinicians should specify:

• Location of the primary hemorrhage (cerebral/supratentorial)
• Presence of intraventricular extension
• Etiology (hypertensive)
• Presence of hydrocephalus, if applicable
• Glasgow Coma Scale score
• Any neurological deficits

This detailed documentation ensures accurate coding and appropriate clinical management for this serious neurological condition that carries significant morbidity and mortality.