P11.0 — Cerebral edema due to birth injury
P11.0 is a billable, specific ICD-10-CM code for cerebral edema due to birth injury. It is valid for submission on a claim.
Other codes that can never be billed with P11.0
These codes carry an Excludes1 note pointing at P11.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading P11.0 alone.
Risk adjustment
P11.0 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 248 Intracranial Hemorrhage0.239 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
P11.0 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56612Billing and Coding: CT of the Head
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
How P11.0 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to P11.0.
- Edema, edematous›brain›due to birth injury
- Edema, edematous›brain›newborn›birth injury
- Pressure›increased›intracranial benign,›injury at birth
Related codes at this level
Codes that share P11. If P11.0 is not quite right, the correct code is usually one of these.
Questions about P11.0
- Is P11.0 a billable ICD-10-CM code?
- Yes. P11.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does P11.0 sit in the tabular list?
- Certain conditions originating in the perinatal period (P00-P96), in the block Birth trauma (P10-P15).