I60.4
BillableNontraumatic subarachnoid hemorrhage from basilar artery
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is I60.4 an HCC code?
Yes. I60.4 maps to Cerebral Hemorrhage under the CMS-HCC V28 risk adjustment model (and Intracranial Hemorrhage under V24).
HCC Category Mapping
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 I60.4
For I60.4to 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 I60.4 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
I60.4 is the ICD-10-CM diagnosis code for nontraumatic subarachnoid hemorrhage from basilar artery. Bleeding in the space surrounding the brain caused by a ruptured blood vessel in the basilar artery, not due to trauma or injury. This is a serious condition that requires immediate medical attention. I60.4 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, I60.4 maps to Cerebral Hemorrhage (HCC 248) with a community, non-dual, aged base RAF weight of 0.289. Under the older CMS-HCC V24 model, I60.4 maps to Intracranial Hemorrhage (HCC 99) with a community, non-dual, aged base RAF weight of 0.262. 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.
Verify the hemorrhage is nontraumatic (not caused by head injury); if trauma is present, use a different code from the S06 series. Because I60.4 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 I60.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the hemorrhage is nontraumatic (not caused by head injury); if trauma is present, use a different code from the S06 series
- •Document the specific artery involved (basilar artery) in the medical record to support accurate code selection, as this distinguishes it from other subarachnoid hemorrhage locations
Clinical Significance
Nontraumatic subarachnoid hemorrhage from the basilar artery is a particularly dangerous posterior circulation hemorrhage. The basilar artery supplies the brainstem and cerebellum, and hemorrhage here can cause devastating neurological deficits including coma, locked-in syndrome, cranial nerve palsies, and death. Basilar artery aneurysms are technically challenging to treat.
Documentation Requirements
- ✓Provider must document nontraumatic subarachnoid hemorrhage from the basilar artery
- ✓Imaging confirmation: computed tomography angiography or conventional angiography showing basilar artery as source
- ✓Aneurysm location on the basilar artery: tip, trunk, or origin
- ✓Brainstem function assessment
- ✓Neurological status including cranial nerve examination
- ✓Treatment approach: endovascular vs surgical (basilar aneurysms are often treated endovascularly)
Commonly Confused Codes
- •I60.50 — Nontraumatic subarachnoid hemorrhage from vertebral artery: vertebral arteries feed into the basilar but are separate vessels
- •I60.30 — Nontraumatic subarachnoid hemorrhage from posterior communicating artery: different posterior circulation artery
- •I60.7 — Nontraumatic subarachnoid hemorrhage from unspecified intracranial artery: nonspecific
- •I61.3 — Nontraumatic intracerebral hemorrhage in brain stem: bleeding within brainstem tissue, not subarachnoid
- •I60.8 — Other nontraumatic subarachnoid hemorrhage: other specified arteries