P52.4
BillableIntracerebral (nontraumatic) hemorrhage of newborn
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is P52.4 an HCC code?
Yes. P52.4 maps to Cerebral Hemorrhage under the CMS-HCC V28 risk adjustment model.
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 P52.4
For P52.4 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 P52.4 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
P52.4 is the ICD-10-CM diagnosis code for intracerebral (nontraumatic) hemorrhage of newborn. Bleeding within the brain tissue itself (not in the ventricles or surrounding spaces) in a newborn without trauma. P52.4 sits in the ICD-10-CM chapter for certain conditions originating in the perinatal period (p00-p96), within the section covering hemorrhagic and hematological disorders of newborn (p50-p61).
Under the CMS-HCC V28 risk adjustment model, P52.4 maps to Cerebral Hemorrhage (HCC 248) with a community, non-dual, aged base RAF weight of 0.289. P52.4 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.
Intracerebral hemorrhage differs from intraventricular hemorrhage; ensure documentation specifies the location within brain tissue. Because P52.4 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 P52.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Intracerebral hemorrhage differs from intraventricular hemorrhage; ensure documentation specifies the location within brain tissue
- •This is distinct from subdural or subarachnoid hemorrhages; verify the exact location documented by the clinician
Clinical Significance
Intracerebral hemorrhage of newborn represents bleeding directly into brain tissue rather than the ventricular system, indicating significant parenchymal injury. This condition carries high risk for focal neurological deficits, seizures, and long-term neurodevelopmental complications, requiring intensive neurological monitoring and often specialized neurocritical care management.
Documentation Requirements
- ✓Imaging confirming bleeding within brain parenchyma
- ✓Location and extent of intracerebral hemorrhage
- ✓Gestational age and birth weight
- ✓Neurological examination findings
- ✓Associated seizure activity
- ✓Exclusion of traumatic causes
- ✓Serial imaging results
- ✓Neurosurgical consultation if indicated