ICD-10 P11.2
Billable / Specific MCCUnspecified brain damage due to birth injury
About ICD-10-CM P11.2
ICD-10-CM code P11.2 represents Unspecified brain damage due to birth injury. This is a billable/specific code in the Perinatal Period chapter (block P11). The 2026 edition of ICD-10-CM P11.2 became effective on October 1, 2025.
Coding Tips for P11.2
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
P11.2 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inpatient DRG Impact, MCC
codes Unspecified brain damage due to birth injury. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for P11.2
Local Coverage Determinations (LCDs) from CMS MACs that list P11.2 as a covered diagnosis.
Showing top 10 of 12 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing P11.2.
1 Medicare
CPT Codes Commonly Billed with P11.2
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert P11.2 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| P11.2 | 7670 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To P11.2
Other codes in section P10-P15 (Birth trauma).
ICD-10 P11.2, Billing FAQ
Is ICD-10 code P11.2 billable? +
Yes, P11.2 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is P11.2 a CC or MCC for inpatient DRG? +
Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What ICD-9 codes does P11.2 map to? +
Per CMS GEMs, P11.2 maps to ICD-9 codes: 7670. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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