P52.21

Billable

Intraventricular (nontraumatic) hemorrhage, grade 3, of newborn

HCC Category Mapping

V28HCC 248 — Cerebral Hemorrhage

0.289

What This Code Means

A newborn has more severe bleeding in the ventricles of the brain that did not result from trauma, with the bleeding extending into the brain tissue surrounding the ventricles.

Coding Tips

•Grade 3 IVH includes intraventricular hemorrhage with ventricular dilation; imaging must document this extension
•Document associated complications such as hydrocephalus, seizures, or developmental concerns

Clinical Significance

Grade 3 intraventricular hemorrhage represents severe bleeding into the brain's ventricular system with ventricular dilatation, indicating significant brain injury in newborns. This condition carries high risk for post-hemorrhagic hydrocephalus, neurodevelopmental delays, and cerebral palsy, requiring intensive neurological monitoring and often neurosurgical intervention.

Documentation Requirements

✓Head ultrasound or MRI showing Grade 3 IVH
✓Evidence of ventricular dilatation
✓Gestational age and birth weight
✓Serial head circumference measurements
✓Neurological status assessments
✓Associated complications documentation
✓Neurosurgical consultation if indicated
✓Long-term follow-up planning

Commonly Confused Codes

P52.1 — Grade 2 IVH, without ventricular dilatation P52.22 — Grade 4 IVH, most severe with parenchymal involvement P52.3 — Unspecified IVH when grade unclear G91.1 — Obstructive hydrocephalus, different etiology

Code Hierarchy

└P52Intracranial nontraumatic hemorrhage of newborn └P52.2Intraventricular (nontraumatic) hemorrhage, grade 3 and grade 4, of newborn └P52.21Intraventricular (nontraumatic) hemorrhage, grade 3, of newborn

└P52.21Intraventricular (nontraumatic) hemorrhage, grade 3, of newborn