Performance Measurement Network

Question: Why is ICD-9-CM Principal Diagnosis Code 436 used for ischemic stroke?

Could you please provide the rationale for why ICD-9-CM Principal Diagnosis Code 436 is used for inclusion in the stroke initial patient population? In the 2010 ICD-9-CM Manual, Volume 1, October 2009, code 436 excludes any condition classifiable to categories 430-435, and excludes any CVA that is ischemic, embolic, hemorrhagic, thrombotic or postoperative.


ICD-9-CM Principal Diagnosis Code 436 (Acute, but Ill-defined Cerebrovascular Disease) was at one time the only stroke code available. It remains on the ischemic stroke list because unfortunately, some people have not changed their coding practices, and continue to use it for stroke. The next time that the ischemic code list is reviewed by the Advisory Panel, we will bring up code 436 for discussion. Thank you for your inquiry.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: STK, Principal Diagnosis 436, Appendix: Code tables

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