Skip to content

P10.3

Billable

Subarachnoid hemorrhage due to birth injury

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

Is P10.3 an HCC code?

Yes. P10.3 maps to Cerebral Hemorrhage under the CMS-HCC V28 risk adjustment model.

HCC Category Mapping

V28HCC 248Cerebral Hemorrhage
0.289

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 P10.3

For P10.3 to 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 P10.3 during that encounter — not just copy-forwarded from a problem list.

What This Code Means

P10.3 is the ICD-10-CM diagnosis code for subarachnoid hemorrhage due to birth injury. Bleeding in the space between the brain and its outermost membrane that results from birth injury. P10.3 sits in the ICD-10-CM chapter for certain conditions originating in the perinatal period (p00-p96), within the section covering birth trauma (p10-p15).

Under the CMS-HCC V28 risk adjustment model, P10.3 maps to Cerebral Hemorrhage (HCC 248) with a community, non-dual, aged base RAF weight of 0.289. P10.3 was not retained as a payment HCC under the older V24 model, so V28 introduced or recategorized it during the 2024–2026 phase-in. 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.

Document the severity and extent of hemorrhage as this affects clinical management and prognosis. Because P10.3 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 P10.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • Document the severity and extent of hemorrhage as this affects clinical management and prognosis
  • Distinguish from spontaneous subarachnoid hemorrhage by confirming birth trauma as the cause

Clinical Significance

Subarachnoid hemorrhage from birth injury indicates significant trauma during delivery that can result in neurological complications and long-term developmental issues. This condition requires careful monitoring for complications such as seizures and increased intracranial pressure in the neonatal period.

Documentation Requirements

  • Imaging studies confirming subarachnoid bleeding
  • Clear documentation of birth trauma as etiology
  • Assessment of hemorrhage extent and clinical significance
  • Neurological status and examination findings
  • Documentation of delivery complications or instrumental delivery
  • Monitoring for seizure activity and neurological changes
  • Exclusion of other causes of neonatal bleeding
  • Long-term neurological follow-up planning

Commonly Confused Codes

  • P10.2 — Intraventricular hemorrhage due to birth injury (different bleeding location)
  • I60.9 — Nontraumatic subarachnoid hemorrhage (adult condition, not birth-related)
  • P52.5 — Subarachnoid hemorrhage (spontaneous neonatal SAH)
  • P10.1 — Subdural hemorrhage due to birth injury (different hemorrhage location)
  • P11.1 — Other specified brain damage due to birth injury (non-hemorrhagic injury)

Code Hierarchy

Open P10.3 in the Interactive Encoder

See full code details, AI coding tips, HCC mappings, and related codes in our interactive encoder. Start your 14-day Pro trial — no credit card required.