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P11.0 ICD-10-CM Code: Cerebral edema due to birth injury

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Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Risk adjustment
CMS-HCC V28: 1 category

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

The tabular list publishes no instructional note for this code itself.

Where it sits Source: CMS/NCHS

Under:Chapter 16: Certain Conditions Originating in the Perinatal PeriodP10-P15 Birth traumaP11 Other birth injuries to central nervous system

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 248 — Intracranial Hemorrhage (supersedes HCC 249)

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coder workflow for P11.0

MedCoder structured workflow — derived from this code’s own official record

Before you code P11.0

  1. P11.0’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is P11.0 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse P11.0 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of P11.0 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • P11.2— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Unspecified brain damage due to birth injury” takes P11.2; specificity in the record moves it back here.

    Full comparison: P11.0 vs P11.2 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Cerebral edema due to birth injury is a billable ICD-10-CM diagnosis code (P11.0).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

  • MCC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name P11.0 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 2 Excludes1 notes across 2 chapters: G93.6 — Cerebral edema, R60 — Edema, not elsewhere classified.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: MCC — Major Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 39 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 2 MS-DRGs: DRG 791 (MDC 15), DRG 793 (MDC 15).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):PNL008 — Birth trauma (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as MCC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

P10.0 — Subdural hemorrhage due to birth injury, P10.1 — Cerebral hemorrhage due to birth injury, P10.4 — Tentorial tear due to birth injury, P10.8 — Other intracranial lacerations and hemorrhages due to birth injury, P10.9 — Unspecified intracranial laceration and hemorrhage due to birth injury, P11.1 — Other specified brain damage due to birth injury, P11.2 — Unspecified brain damage due to birth injury, P11.9 — Birth injury to central nervous system, unspecified, P15.0 — Birth injury to liver, P15.1 — Birth injury to spleen, P15.2 — Sternomastoid injury due to birth injury, P15.3 — Birth injury to eye, P15.4 — Birth injury to face, P15.5 — Birth injury to external genitalia, P15.6 — Subcutaneous fat necrosis due to birth injury, P15.8 — Other specified birth injuries, P15.9 — Birth injury, unspecified, P29.0 — Neonatal cardiac failure, P29.11 — Neonatal tachycardia, P29.12 — Neonatal bradycardia, +18 more

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Intracranial Hemorrhage) for risk-adjusted payment.

I62.03 — Nontraumatic chronic subdural hemorrhage, I62.1 — Nontraumatic extradural hemorrhage, I62.9 — Nontraumatic intracranial hemorrhage, unspecified, P10.0 — Subdural hemorrhage due to birth injury, P10.1 — Cerebral hemorrhage due to birth injury, P10.2 — Intraventricular hemorrhage due to birth injury, P10.3 — Subarachnoid hemorrhage due to birth injury, P10.4 — Tentorial tear due to birth injury, P10.8 — Other intracranial lacerations and hemorrhages due to birth injury, P10.9 — Unspecified intracranial laceration and hemorrhage due to birth injury, P11.1 — Other specified brain damage due to birth injury, P11.2 — Unspecified brain damage due to birth injury, P52.0 — Intraventricular (nontraumatic) hemorrhage, grade 1, of newborn, P52.1 — Intraventricular (nontraumatic) hemorrhage, grade 2, of newborn, P52.21 — Intraventricular (nontraumatic) hemorrhage, grade 3, of newborn, P52.22 — Intraventricular (nontraumatic) hemorrhage, grade 4, of newborn, P52.3 — Unspecified intraventricular (nontraumatic) hemorrhage of newborn, P52.4 — Intracerebral (nontraumatic) hemorrhage of newborn, P52.5 — Subarachnoid (nontraumatic) hemorrhage of newborn, P52.6 — Cerebellar (nontraumatic) and posterior fossa hemorrhage of newborn, +32 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Ischemic or Unspecified Stroke

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Birth trauma).

P10.0 — Subdural hemorrhage due to birth injury, P10.1 — Cerebral hemorrhage due to birth injury, P10.2 — Intraventricular hemorrhage due to birth injury, P10.3 — Subarachnoid hemorrhage due to birth injury, P10.4 — Tentorial tear due to birth injury, P10.8 — Other intracranial lacerations and hemorrhages due to birth injury, P10.9 — Unspecified intracranial laceration and hemorrhage due to birth injury, P11.1 — Other specified brain damage due to birth injury, P11.2 — Unspecified brain damage due to birth injury, P11.3 — Birth injury to facial nerve, P11.4 — Birth injury to other cranial nerves, P11.5 — Birth injury to spine and spinal cord, P11.9 — Birth injury to central nervous system, unspecified, P12.0 — Cephalhematoma due to birth injury, P12.1 — Chignon (from vacuum extraction) due to birth injury, P12.2 — Epicranial subaponeurotic hemorrhage due to birth injury, P12.3 — Bruising of scalp due to birth injury, P12.4 — Injury of scalp of newborn due to monitoring equipment, P12.81 — Caput succedaneum, P12.89 — Other birth injuries to scalp, +23 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Edema, edematous”, “Pressure”; these codes share that main term but sit in a different category of the Tabular List.

J81.0 — Acute pulmonary edema (lung, acute), J81.1 — Chronic pulmonary edema (lung), J98.59 — Other diseases of mediastinum, not elsewhere classified (mediastinum), K86.89 — Other specified diseases of pancreas (pancreas), N44.8 — Other noninflammatory disorders of the testis (testis), N48.89 — Other specified disorders of penis (penis), N50.89 — Other specified disorders of the male genital organs (scrotum), N88.8 — Other specified noninflammatory disorders of cervix uteri (cervix), N90.89 — Other specified noninflammatory disorders of vulva and perineum (vulva), O90.89 — Other complications of the puerperium, not elsewhere classified (cervix, puerperal, postpartum), P29.0 — Neonatal cardiac failure (lung, with heart condition or failure, newborn), P52.4 — Intracerebral (nontraumatic) hemorrhage of newborn (brain, newborn), P83.30 — Unspecified edema specific to newborn (newborn), P83.39 — Other edema specific to newborn (newborn, specified NEC), Q82.0 — Hereditary lymphedema (Milroy's), R03.1 — Nonspecific low blood-pressure reading (hyposystolic, incidental reading, without diagnosis of hypotension), R07.89 — Other chest pain (chest), R60.0 — Localized edema (legs), R60.1 — Generalized edema (generalized), R60.9 — Edema, unspecified, +46 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of P11.0 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run P11.0 with these 2 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 248 — Intracranial Hemorrhage [CMS-HCC]: “Intracranial Hemorrhage — supersedes HCC 249 (Ischemic or Unspecified Stroke)”— CMS-HCC V28 · 2026

MS-DRG Grouper

  • MCC — Major Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (MCC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2027
  • DRG 791 — PREMATURITY WITH MAJOR PROBLEMS[MS-DRG]: “PREMATURITY WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
  • DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS[MS-DRG]: “FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027

MDC crossing

Index entries

  • Edema, edematous (infectious) (pitting) (toxic), brain (cytotoxic) (vasogenic), due to birth injury[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Edema, edematous (infectious) (pitting) (toxic), brain (cytotoxic) (vasogenic), newborn (anoxia or hypoxia), birth injury[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Pressure, increased, intracranial benign,, injury at birth[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (3)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "P11.0 — Cerebral edema due to birth injury." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/p11.0-cerebral-edema-due-to-birth-injury

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Cerebral edema due to birth injury

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to P11.0 in its code family, with their registry titles.

View all codes in the P11 family