Intraparenchymal Hemorrhage ICD-10-CM Codes

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Key Takeaways

Intraparenchymal hemorrhage ICD-10-CM codes fall under the I61.x category for nontraumatic intracerebral hemorrhage

Accurate site-specific coding (subcortical, cortical, brain stem, cerebellum) reduces claim denials

Always report the underlying cause alongside the hemorrhage code for complete documentation

Sequelae codes (I69.1x) apply when documenting long-term effects of a previous hemorrhage

Use additional code R29.7 to capture the NIHSS stroke scale score when available

Intraparenchymal hemorrhage ICD-10-CM codes help clinicians accurately document one of the most serious types of stroke. This condition involves bleeding directly into the brain tissue and accounts for roughly 10 to 15 percent of all strokes, according to the American Heart Association. However, coding errors remain common because the I61.x series requires precise anatomical location. In this guide, you will find every code you need, along with documentation tips and clinical scenarios to support accurate billing.

What Is Intraparenchymal Hemorrhage?

Intraparenchymal hemorrhage refers to bleeding that occurs within the brain parenchyma itself. In most cases, hypertension is the primary cause. Additionally, vascular malformations, anticoagulant use, and amyloid angiopathy can trigger this type of bleed.

Symptoms typically include sudden severe headache, focal neurological deficits, and altered consciousness. For example, a patient with subcortical bleeding may present with contralateral weakness, while cerebellar haemorrhage often causes ataxia and vomiting. As a result, rapid imaging with CT or MRI is essential for both diagnosis and accurate ICD-10-CM code assignment.

The distinction between intraparenchymal and other intracranial haemorrhages matters for coding. Specifically, intraparenchymal bleeds occur within the brain tissue, while subdural and epidural bleeds involve the meninges. Therefore, coders must carefully review imaging reports to select the correct code category.

Complete Intraparenchymal Hemorrhage ICD-10-CM Codes List

The following table lists all primary intraparenchymal hemorrhage ICD-10-CM codes in the I61.x series. Each code is billable and requires supporting clinical documentation.

Primary I61.x Codes for Nontraumatic Intracerebral Hemorrhage

Related Intracranial Hemorrhage Codes

In addition to the I61.x series, you may need these related codes for comprehensive documentation:

Sequelae Codes for Intraparenchymal Hemorrhage ICD-10-CM Coding

When documenting long-term effects of a previous haemorrhage, use the I69.1x sequelae codes:

Coding Guidelines for Intraparenchymal Hemorrhage ICD-10-CM Codes

Accurate coding starts with thorough clinical documentation. Furthermore, understanding the ICD-10-CM guidelines specific to cerebrovascular conditions helps prevent costly errors.

Specificity Requirements

ICD-10-CM guidelines require the highest level of specificity available. For instance, if imaging confirms a subcortical bleed, you must use I61.0 rather than I61.9 (unspecified). Similarly, code I61.2 should only appear when the radiologist cannot determine whether the haemorrhage is subcortical or cortical.

In addition, always report the underlying aetiology. Hypertensive heart disease (I11.x), anticoagulant adverse effects (T45.515A), or vascular malformation codes should accompany the hemorrhage code.

Excludes Notes to Remember

The I61 category includes important excludes notes. Consequently, you should be aware of these:

• Excludes1: Sequelae of intracerebral hemorrhage (I69.1-) cannot be reported with an active I61.x code
• Excludes2: Traumatic intracerebral hemorrhage uses injury codes (S06.x), not I61.x

Additional Code Requirements

ICD-10-CM instructs coders to use an additional code to identify the NIHSS score (R29.7-) when documented. This supplementary code strengthens the clinical picture and supports medical necessity for acute interventions.

Documentation Requirements for Intraparenchymal Hemorrhage

Complete documentation is essential for clean claims. As a result, every encounter note should include these elements:

• Anatomical location of the haemorrhage (subcortical, cortical, brain stem, cerebellum, or intraventricular)
• Laterality (left hemisphere, right hemisphere, or bilateral)
• Underlying cause (hypertension, anticoagulation, vascular malformation, amyloid angiopathy)
• Acuity (acute, subacute, or chronic presentation)
• NIHSS score when assessed
• Associated symptoms and neurological deficits

Using digital forms can help standardise stroke documentation across your practice. Furthermore, structured templates ensure that coders have the information they need without querying the clinician.

“Since switching to Pabau, our clinical documentation has become far more structured. The digital forms ensure that every stroke encounter captures the exact location and severity details our billing team needs for accurate ICD-10-CM coding.”

Dr Jonathan Garabette

Founder, London Psychiatry Clinic

Common Coding Mistakes With Intraparenchymal Hemorrhage ICD-10-CM Codes

Even experienced coders make errors with cerebrovascular codes. Therefore, watch out for these frequent mistakes:

Using Unspecified Codes When Specificity Exists

The most common error involves selecting I61.9 when imaging clearly identifies the haemorrhage location. Auditors flag this pattern because it suggests incomplete code review. Similarly, using I61.2 (hemisphere, unspecified) when the report states "left basal ganglia haemorrhage" misses the specificity requirement for I61.0.

Confusing Traumatic and Nontraumatic Codes

Intraparenchymal hemorrhage ICD-10-CM codes in the I61.x range apply exclusively to nontraumatic bleeds. In contrast, trauma-related intracerebral haemorrhage requires S06.3x codes. Mixing these categories leads to claim denials and compliance concerns.

Missing Sequelae Code Transitions

When a patient returns months after the initial event with residual deficits, you must transition from the acute I61.x code to the appropriate I69.1x sequelae code. For example, a patient with ongoing left-sided weakness from a previous right subcortical haemorrhage should receive I69.15 (hemiplegia following nontraumatic intracerebral hemorrhage), not I61.0.

Forgetting Associated Condition Codes

Failing to report the underlying condition alongside the hemorrhage code creates an incomplete clinical picture. For instance, a hypertensive patient with intracerebral bleeding needs both I61.0 and the appropriate hypertension code (I10 or I11.x).

Clinical Scenarios for Intraparenchymal Hemorrhage Coding

Real-world examples help clarify code selection. Below are common presentations and their correct intraparenchymal hemorrhage ICD-10-CM codes.

Scenario 1: Hypertensive Subcortical Haemorrhage

A 62-year-old man presents with sudden right-sided weakness and dysarthria. CT scan reveals a 3 cm left basal ganglia haemorrhage. He has a history of poorly controlled hypertension.

Primary code: I61.0 (Nontraumatic intracerebral hemorrhage in hemisphere, subcortical) Additional codes: I10 (Essential hypertension), R29.710 (NIHSS score 0-9, if documented)

Scenario 2: Cerebellar Haemorrhage With Intraventricular Extension

A 58-year-old woman arrives with severe headache, vomiting, and ataxia. MRI shows cerebellar haemorrhage with extension into the fourth ventricle.

Primary code: I61.4 (Nontraumatic intracerebral hemorrhage in cerebellum) Secondary code: I61.5 (Nontraumatic intracerebral hemorrhage, intraventricular)

Scenario 3: Follow-up for Residual Deficits

A patient returns six months after a cortical haemorrhage with persistent aphasia and right arm weakness.

Primary codes: I69.12 (Speech and language deficits following nontraumatic intracerebral hemorrhage), I69.13 (Monoplegia of upper limb following nontraumatic intracerebral hemorrhage)

How to Improve Your Intraparenchymal Hemorrhage ICD-10-CM Coding Accuracy

Reducing coding errors requires a systematic approach. Consequently, consider these strategies for your practice:

1. Standardise documentation templates – Create stroke-specific encounter forms that prompt clinicians to record haemorrhage location, laterality, and severity. A client record system with built-in templates makes this straightforward.

2. Train staff on specificity requirements – Ensure coders understand the difference between subcortical and cortical locations. Regular training sessions reduce reliance on unspecified codes.

3. Implement query protocols – When documentation lacks anatomical specificity, coders should query the treating clinician before defaulting to unspecified codes.

4. Audit regularly – Monthly reviews of I61.x coding patterns help identify trends. A compliance management system can automate these audits.

5. Use clinical decision support – Integrate ICD-10-CM code suggestions into your AI-powered documentation tools to catch coding gaps at the point of care.

Maintaining HIPAA compliance throughout the coding process protects patient data while supporting accurate billing. Furthermore, a thorough HIPAA compliance checklist helps practices stay audit-ready.

Streamline Your ICD-10-CM Coding With Pabau

Managing intraparenchymal hemorrhage ICD-10-CM codes becomes simpler with the right practice management platform. Pabau offers claims management tools that integrate directly with your clinical documentation workflow.

With structured medical forms, automated paperless workflows, and built-in compliance features, your team can focus on patient care while maintaining coding accuracy. Start your free trial today and see how Pabau transforms your practice operations.

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Frequently Asked Questions About Intraparenchymal Hemorrhage ICD-10-CM Codes