2026 ICD-10-CM Diagnosis Code P11.2Unspecified brain damage due to birth injury
ICD-10-CM Codes›P00–P96›P10-P15›P11
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Risk Adjusts — HCC 248
- Chronic Condition
P11.2 is a billable ICD-10-CM diagnosis code for unspecified brain damage due to birth injury. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 791, 793. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 39 closely related codes. Coders also document this condition as cerebral injury due to birth trauma. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Birth trauma.
For Medicare Advantage risk adjustment, P11.2 maps to CMS-HCC Category 248 (Intracranial Hemorrhage) under the V28 model, adding a risk factor of about 0.239 for a community, non-dual, aged beneficiary in payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
P11.2 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2026.
Source: CMS Payment Year 2026 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Cerebral injury due to birth trauma
- Chorea due to cerebral injury due to birth trauma
- Chorea due to injury of head
- Paralysis from birth trauma
- Spastic paralysis due to birth injury
- Spastic paralysis due to intracranial birth injury
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
intracranial P11.2
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Childbirth Problems
Childbirth is the process of giving birth to a baby. It includes labor and delivery. Usually everything goes well, but problems can happen. They may cause a risk to the mother, baby, or both. Some of the more common childbirth problems include:
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert P11.2 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About P11.2Overview
What is the ICD-10 code for unspecified brain damage due to birth injury?
The ICD-10-CM code for unspecified brain damage due to birth injury is P11.2 (sometimes written as P112). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is P11.2 (Other birth injuries to central nervous system) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report unspecified brain damage due to birth injury on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does P11.2 group to?
When unspecified brain damage due to birth injury is the principal diagnosis on an inpatient stay, it groups to MS-DRG 791, 793, with relative weights from 4.0590 to 4.1696 depending on complications. Higher weights mean higher Medicare reimbursement.
Is P11.2 a CC or MCC?
CMS lists P11.2 as an MCC (major complication or comorbidity) for FY 2026. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 39 closely related codes in its exclusion list.
What is the ICD-9 equivalent of P11.2?
Under the General Equivalence Mappings, unspecified brain damage due to birth injury converts to ICD-9-CM 767.0 (cerebral hem at birth). The mapping is approximate, so confirm the match fits the documentation.
What HCC is P11.2?
P11.2 (unspecified brain damage due to birth injury) maps to CMS-HCC Category 248 (Intracranial Hemorrhage), commonly written as HCC 248, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It does not map to any RxHCC in the Part D prescription drug model.
Does P11.2 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, P11.2 adds a risk adjustment factor of about 0.239 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.081 to 0.377 depending on the payment segment). HCC 248 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 248 category page.
