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I60.11

Billable

Nontraumatic subarachnoid hemorrhage from right middle cerebral artery

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

Is I60.11 an HCC code?

Yes. I60.11 maps to Intracranial Hemorrhage under the CMS-HCC V28 risk adjustment model (and Intracranial Hemorrhage under V24).

HCC Category Mapping

V28HCC 248Intracranial Hemorrhage
0.239
V24HCC 99Intracranial Hemorrhage
0.230
ESRDHCC 99Intracranial Hemorrhage
0.062

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

MEAT Criteria for I60.11

For I60.11to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.

  • MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
  • EEvaluate: test results, medication response, or physical findings reviewed by the provider
  • AAssess: explicit mention in the assessment or plan with acknowledgment of status
  • TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed I60.11 during that encounter — not just copy-forwarded from a problem list.

What This Code Means

I60.11 is the ICD-10-CM diagnosis code for nontraumatic subarachnoid hemorrhage from right middle cerebral artery. Sudden bleeding in the space around the brain from a ruptured right middle cerebral artery, not caused by trauma. I60.11 sits in the ICD-10-CM chapter for diseases of the circulatory system (i00-i99), within the section covering cerebrovascular diseases (i60-i69).

Under the CMS-HCC V28 risk adjustment model, I60.11 maps to Intracranial Hemorrhage (HCC 248) with a community, non-dual, aged base RAF weight of 0.239. Under the older V24 model, I60.11 mapped to the same category but with a base RAF weight of 0.230 — V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

The middle cerebral artery is the most common site for subarachnoid hemorrhage; ensure right-sided location is documented. Because I60.11 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for I60.11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • The middle cerebral artery is the most common site for subarachnoid hemorrhage; ensure right-sided location is documented
  • This is a life-threatening emergency requiring immediate intervention

Clinical Significance

Nontraumatic subarachnoid hemorrhage from the right middle cerebral artery typically results from rupture of an aneurysm at the right middle cerebral artery bifurcation. This can cause left-sided motor deficits and, if in the dominant hemisphere, may affect speech and language. The middle cerebral artery is the most commonly affected artery in cerebral aneurysm disease.

Documentation Requirements

  • Provider must document nontraumatic subarachnoid hemorrhage from the RIGHT middle cerebral artery
  • Imaging confirmation: computed tomography angiography or conventional angiography
  • Aneurysm characteristics: size, morphology, neck width
  • Neurological assessment with lateralized deficits
  • Severity grading scale score
  • Intervention details: surgical clipping or endovascular coiling of right middle cerebral artery aneurysm

Commonly Confused Codes

  • I60.10 — Nontraumatic subarachnoid hemorrhage from unspecified middle cerebral artery: unspecified laterality
  • I60.12 — Nontraumatic subarachnoid hemorrhage from left middle cerebral artery: left side, not right
  • I60.01 — Nontraumatic subarachnoid hemorrhage from right carotid siphon: different artery, same side
  • I61.1 — Nontraumatic intracerebral hemorrhage in hemisphere, cortical: intraparenchymal, not subarachnoid
  • I63.311 — Cerebral infarction due to thrombosis of right middle cerebral artery: ischemic, not hemorrhagic

Code Hierarchy

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