ICD-10 P91.829
Billable / Specific HCC v28: 100 MCCNeonatal cerebral infarction, unspecified side
About ICD-10-CM P91.829
ICD-10-CM code P91.829 represents Neonatal cerebral infarction, unspecified side. This is a billable/specific code in the Perinatal Period chapter (block P91). The 2026 edition of ICD-10-CM P91.829 became effective on October 1, 2025.
Coding Tips for P91.829
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
P91.829 is a CMS-HCC v28 risk-adjustment code (category 100). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
P91.829 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.
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, MCC
codes Neonatal cerebral infarction, unspecified side. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for P91.829
Local Coverage Determinations (LCDs) from CMS MACs that list P91.829 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing P91.829.
1 Cigna
CPT Codes Commonly Billed with P91.829
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.
Codes Adjacent To P91.829
Other codes in section P90-P96 (Other disorders originating in the perinatal period).
ICD-10 P91.829, Billing FAQ
Is ICD-10 code P91.829 billable? +
Yes, P91.829 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does P91.829 affect Medicare Advantage HCC risk adjustment? +
Yes. P91.829 maps to CMS-HCC v28 category 100. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is P91.829 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.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 16, 2026.
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