P11.9 — Birth injury to central nervous system, unspecified
P11.9 is a billable, specific ICD-10-CM code for birth injury to central nervous system, unspecified. It is valid for submission on a claim.
Risk adjustment
P11.9 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
P11.9 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 P11.9 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 P11.9.
- Birth›injury NOS›central nervous system NOS
- Hemiplegia›newborn NEC›birth injury
Related codes at this level
Codes that share P11. If P11.9 is not quite right, the correct code is usually one of these.
Questions about P11.9
- Is P11.9 a billable ICD-10-CM code?
- Yes. P11.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does P11.9 sit in the tabular list?
- Certain conditions originating in the perinatal period (P00-P96), in the block Birth trauma (P10-P15).