N92.0 - Excessive and frequent menstruation with regular cycle

Clinical Definition

Carotid artery dissection occurs when blood enters the arterial wall through an intimal tear, creating a false lumen and potentially compromising blood flow. This can happen spontaneously or due to trauma.

Documentation Requirements

• Laterality

  • Right carotid artery

  • Left carotid artery

  • Bilateral involvement

• Timing/Acuity

  • Initial encounter

  • Subsequent encounter

  • Sequela

• Cause

  • Traumatic vs. spontaneous

  • If traumatic, specify type of trauma

• Location

  • Common carotid

  • Internal carotid

  • External carotid

• Associated Conditions

  • Presence/absence of cerebral infarction

  • Neurological deficits

  • Horner's syndrome if present

Common Synonyms

• Carotid tear

• Arterial wall separation

• Carotid tear

• Internal carotid dissection

• Neck artery tear

Coding Conflicts

Excludes1:

• Dissection of precerebral arteries due to other conditions

• Dissection of vertebral arteries (S15.111, S15.112)

Scribing.io Automation

The AI scribe automatically:

1. Identifies anatomical terms ("carotid," "internal carotid," "common carotid")

2. Captures trauma mechanism if mentioned

3. Notes laterality keywords

4. Flags neurological symptoms

5. Records timing indicators for encounter specification

6. Links associated conditions when documented in same note

Remember to dictate clearly whether the dissection is traumatic or spontaneous, as these code to different ICD-10 categories.