Is P91.811 a billable ICD-10-CM code?

Yes. P91.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does P91.811 sit in the tabular list?

Certain conditions originating in the perinatal period (P00-P96), in the block Other disorders originating in the perinatal period (P90-P96).

P91.811

P91.811 — Neonatal encephalopathy in diseases classified elsewhere

Billable / specific codeICD-10-CMPOA exempt

P91.811 is a billable, specific ICD-10-CM code for neonatal encephalopathy in diseases classified elsewhere. It is valid for submission on a claim.

Code first

The underlying condition must be sequenced before this code.

underlying condition, if known, such as:
congenital cirrhosis (of liver) (P78.81)
intracranial nontraumatic hemorrhage of newborn (P52.-)
kernicterus (P57.-)

Risk adjustment

P91.811 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 202 Coma, Brain Compression/Anoxic Damage0.543 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

P91.811 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57204Billing and Coding: MRI and CT Scans of the Head and Neck

How P91.811 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 P91.811.

Encephalopathy›neonatal›in diseases classified elsewhere

Related codes at this level

Codes that share P91.81. If P91.811 is not quite right, the correct code is usually one of these.

P91.819Neonatal encephalopathy, unspecified

Questions about P91.811

Is P91.811 a billable ICD-10-CM code?: Yes. P91.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does P91.811 sit in the tabular list?: Certain conditions originating in the perinatal period (P00-P96), in the block Other disorders originating in the perinatal period (P90-P96).