P11.1
P11.1: Other specified brain damage due to birth injury
Billable / specific codeICD-10-CM
P11.1 is a billable, specific ICD-10-CM code for other specified brain damage due to birth injury. It is valid for submission on a claim.
Check P11.1 with the rest of the claim: free scrubberRisk adjustment
P11.1 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
P11.1 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
Alphabetic index entries that lead here
- Birth›injury NOS›basal ganglia
- Birth›injury NOS›cerebellum
- Encephalopathy›in›birth injury
- Pressure›brain›injury at birth NEC
- Birth›injury NOS›meninges›brain
Code history
Unchanged in every release from FY2024 to FY2027.