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P11.5 ICD-10-CM Code: Birth injury to spine and spinal cord

Compare with another code for P11.5Check this code on a claim

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

Coding at a Glance

Tabular directives
1 inclusion term
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.

IncludesWhat this code covers
  • Fracture of spine due to birth injury

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 182 — Spinal Cord Disorders/Injuries

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

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for P11.5 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Fracture of spine due to birth injury

Don’t confuse P11.5 with…

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

The codes most likely to be picked instead of P11.5 — 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: P11.5 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

Birth injury to spine and spinal cord is a billable ICD-10-CM diagnosis code (P11.5).

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

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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 P11.5 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 1 Excludes2 note: P13 — Birth injury to skeleton.

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

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 CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Spinal Cord Disorders/Injuries) for risk-adjusted payment.

G90.1 — Familial dysautonomia [Riley-Day], G95.0 — Syringomyelia and syringobulbia, G95.11 — Acute infarction of spinal cord (embolic) (nonembolic), G95.19 — Other vascular myelopathies, G95.20 — Unspecified cord compression, G95.29 — Other cord compression, G95.81 — Conus medullaris syndrome, G95.89 — Other specified diseases of spinal cord, G95.9 — Disease of spinal cord, unspecified, G99.2 — Myelopathy in diseases classified elsewhere, Q00.0 — Anencephaly, Q00.1 — Craniorachischisis, Q00.2 — Iniencephaly, Q01.0 — Frontal encephalocele, Q01.1 — Nasofrontal encephalocele, Q01.2 — Occipital encephalocele, Q01.8 — Encephalocele of other sites, Q01.9 — Encephalocele, unspecified, Q02 — Microcephaly, Q03.0 — Malformations of aqueduct of Sylvius, +230 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.

Quadriplegia, Paraplegia

Same clinical category (CCSR)

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

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, P11.0 — Cerebral edema 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, P11.9 — 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, P12.9 — Birth injury to scalp, unspecified, P13.0 — Fracture of skull due to birth injury, +23 more

Same Index main term, other category

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

O90.2 — Hematoma of obstetric wound (episiotomy), P08.0 — Exceptionally large newborn baby (weight, 4500 grams or more), P08.1 — Other heavy for gestational age newborn (weight, 4000 grams to 4499 grams), P10.0 — Subdural hemorrhage due to birth injury (injury NOS, subdural hemorrhage), P10.1 — Cerebral hemorrhage due to birth injury (injury NOS, laceration, brain), P10.2 — Intraventricular hemorrhage due to birth injury (injury NOS, intraventricular hemorrhage), P10.3 — Subarachnoid hemorrhage due to birth injury (injury NOS, subarachnoid hemorrhage), P10.4 — Tentorial tear due to birth injury (injury NOS, tentorial tear), P10.8 — Other intracranial lacerations and hemorrhages due to birth injury (extradural, birth injury), P10.9 — Unspecified intracranial laceration and hemorrhage due to birth injury (intracranial, birth injury), P12.2 — Epicranial subaponeurotic hemorrhage due to birth injury (subgaleal), P12.9 — Birth injury to scalp, unspecified (injury NOS, scalp), P13.0 — Fracture of skull due to birth injury (injury NOS, fracture, skull), P13.1 — Other birth injuries to skull (fontanel), P13.2 — Birth injury to femur (injury NOS, fracture, femur), P13.3 — Birth injury to other long bones (injury NOS, fracture, humerus), P13.4 — Fracture of clavicle due to birth injury (injury NOS, fracture, clavicle), P13.8 — Birth injuries to other parts of skeleton (injury NOS, fracture, bone, specified NEC), P13.9 — Birth injury to skeleton, unspecified (injury NOS, fracture, bone), P14.0 — Erb's paralysis due to birth injury (Erb), +592 more

Contextual Map

Every relationship of P11.5 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 P11.5 with this related code in Claim Check

Hierarchy

Referenced by Excludes2 notes

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 182 — Spinal Cord Disorders/Injuries [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

Index entries (17)

  • Birth, injury NOS, fracture, spine[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Birth, injury NOS, meninges, spinal cord[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Birth, injury NOS, paralysis, spinal[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Birth, injury NOS, rupture, spinal cord[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Birth, injury NOS, spinal cord[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Birth, injury NOS, spine[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Dislocation (articular), spine, due to birth trauma[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Fracture, traumatic (abduction) (adduction) (separation), vertebra, vertebral (arch) (body) (column) (neural arch) (pedicle) (spinous process) (transverse process), newborn (birth injury)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • and 9 more

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 (17)

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. "P11.5 — Birth injury to spine and spinal cord." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/p11.5-birth-injury-to-spine-and-spinal-cord

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Birth injury to spine and spinal cord

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 P11.5 in its code family, with their registry titles.

View all codes in the P11 family