P11.2: Unspecified brain damage due to birth injury

Risk adjustment

P11.2 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

P11.2 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

• A56612Billing and Coding: CT of the Head