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ICD-10 Guide
ICD-10 CodesP11.0

P11.0

Billable

Cerebral edema due to birth injury

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 P11.0 is a billable code used to indicate a diagnosis of cerebral edema due to birth injury.

Key Diagnostic Point:

Cerebral edema due to birth injury is a serious condition that occurs when there is an accumulation of excess fluid in the brain tissue of a newborn, often resulting from trauma during the birthing process. This condition can arise from various birth injuries, including those affecting the central nervous system, such as intracranial hemorrhages, and can lead to significant neurological impairment. Birth injuries may occur due to mechanical factors such as prolonged labor, use of forceps, or vacuum extraction. The clinical presentation may include altered consciousness, seizures, and abnormal muscle tone. Diagnosis typically involves imaging studies like ultrasound or MRI to assess the extent of edema and rule out other conditions. Management may include supportive care, monitoring intracranial pressure, and addressing any underlying causes. Early recognition and intervention are crucial to minimize long-term neurological deficits.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of birth injuries
  • Understanding the nuances of cerebral edema versus other neurological conditions
  • The need for detailed documentation of the birth process and any complications
  • Variability in clinical presentation and outcomes among affected infants

Audit Risk Factors

  • Inadequate documentation of the birth process
  • Failure to specify the type of birth injury
  • Misclassification of the severity of the condition
  • Inconsistent coding of associated neurological conditions

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of the birth process, neurological assessments, and imaging results.

Common Clinical Scenarios

Infants presenting with seizures or altered consciousness in the NICU following a traumatic delivery.

Billing Considerations

Accurate coding requires comprehensive documentation of the birth injury and its immediate effects on the infant.

Pediatrics

Documentation Requirements

Ongoing assessments of developmental milestones and neurological evaluations.

Common Clinical Scenarios

Pediatric follow-up for infants with a history of cerebral edema due to birth injury.

Billing Considerations

Consideration of long-term outcomes and potential developmental delays in coding.

Coding Guidelines

Inclusion Criteria

Use P11.0 When
  • Perinatal coding guidelines emphasize the importance of accurate documentation of the birth process, the specific nature of the injury, and any associated conditions
  • Coders should refer to the ICD
  • CM guidelines for coding birth injuries and their sequelae

Exclusion Criteria

Do NOT use P11.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99291CPT Code

Critical care, evaluation and management of the neonate

Clinical Scenario

Used when managing a newborn with cerebral edema in the NICU.

Documentation Requirements

Detailed documentation of critical care services provided.

Specialty Considerations

Neonatologists must document the severity and complexity of care.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of birth injuries, including cerebral edema, which enhances the ability to track and manage these conditions effectively. The granularity of ICD-10 codes helps in better understanding the epidemiology and outcomes of birth injuries.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of birth injuries, including cerebral edema, which enhances the ability to track and manage these conditions effectively. The granularity of ICD-10 codes helps in better understanding the epidemiology and outcomes of birth injuries.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of birth injuries, including cerebral edema, which enhances the ability to track and manage these conditions effectively. The granularity of ICD-10 codes helps in better understanding the epidemiology and outcomes of birth injuries.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Coding for Neonatal Care

Coding & Billing References

  • •
    American Academy of Pediatrics - Coding for Neonatal Care

Frequently Asked Questions

What are the common causes of cerebral edema due to birth injury?

Common causes include mechanical trauma during delivery, such as the use of forceps or vacuum extraction, prolonged labor, and fetal distress leading to hypoxia.