🧬 ICD-10 CM I62.9 — Nontraumatic Intracerebral Hemorrhage, Unspecified
Billable Code Confirmed
ICD-10 CM I62.9 is a complete, five-character ICD-10-CM code requiring no additional specificity to be reported on an inpatient claim. The code is used when documentation confirms a nontraumatic hemorrhage occurring within the brain parenchyma but does not specify the exact anatomical site, such as cerebral lobe, basal ganglia, or brainstem. Because no 6th or 7th character is applicable to this subcategory, I62.9 stands as a final, billable code at this level of the hierarchy.
Non-Billable Parent Codes
I62 — “Other and nontraumatic intracranial hemorrhage” is a non-billable category header; it requires a decimal subdivision specifying the anatomical compartment (subdural, extradural, or intracerebral) before it can be reported. I60 — “Nontraumatic subarachnoid hemorrhage” is a separate three-character category that also requires further subdivision and represents a different bleed location (subarachnoid space rather than brain parenchyma), so it is not interchangeable with I62.9.
Clinical Context
The distinction driving selection of I62.9 versus a more specific code hinges entirely on imaging and physician documentation of the bleed location. When CT or MRI identifies a specific site, such as the basal ganglia, thalamus, or cerebellum, coders should query for or assign a code from the I61 (nontraumatic intracerebral hemorrhage with specified site) category instead, since I62.9 is reserved for cases where the site genuinely cannot be determined or is not documented. I62.9 is most often seen when emergency department or initial admission documentation describes “intracerebral hemorrhage” generally before definitive imaging localization, or in cases where the clinical team’s final documentation never specifies location despite imaging being performed.
Code Classification
ICD-10 CM I62.9 is a diagnosis code used to report the presence of a nontraumatic intracerebral hemorrhage as a clinical condition. It is not a procedure code and carries no laterality or 7th-character extension requirements, distinguishing it structurally from injury codes in Chapter 19 that require episode-of-care extensions.
🔍 Code Description
ICD-10 CM I62.9 represents bleeding within the brain tissue itself that did not result from external trauma, distinguishing it from S06.36- category traumatic brain injuries and from I60.9 subarachnoid hemorrhage, which occurs in the space surrounding the brain rather than within it. This code is assigned when the underlying etiology, often hypertensive vasculopathy, arteriovenous malformation rupture, or anticoagulant-associated bleeding, is documented but the specific intracerebral location cannot be determined from the available imaging or clinical documentation. Patients typically present with acute neurological deficits such as hemiparesis, aphasia, or altered consciousness, and the diagnosis is generally confirmed via non-contrast CT of the head showing hyperdense parenchymal blood.
From a coding standpoint, I62.9 frequently appears as a principal diagnosis on inpatient stroke admissions and pairs closely with codes describing associated neurological deficits, such as R29.818 for facial weakness or hemiplegia codes when residual deficits are present at discharge. Coders should be cautious not to default to I62.9 simply because the admitting diagnosis says “hemorrhagic stroke” without first checking radiology reports for a documented anatomical site, since assigning a more specific code from I61.9’s sibling categories can affect both clinical accuracy and risk adjustment specificity. Additionally, I62.9 should never be used when the hemorrhage is clearly documented as a sequela of a prior stroke event, as that scenario requires a code from the I69 category instead.
🌳 Code Tree / Hierarchy
I62 Other and nontraumatic intracranial hemorrhage ❌ Non-billable
│
├── I62.0- Nontraumatic subdural hemorrhage ❌ Non-billable (requires further subdivision)
│ │
│ ├── I62.00 Nontraumatic subdural hemorrhage, unspecified ✅ Billable
│ └── I62.02 Nontraumatic acute subdural hemorrhage ✅ Billable
│
├── I62.1 Nontraumatic extradural hemorrhage ✅ Billable
│
├── I62.9 Other and unspecified nontraumatic intracranial hemorrhage ❌ Non-billable (category header)
│ │
│ ├── I62.9 Nontraumatic intracerebral hemorrhage, unspecified ◀ THIS CODE ✅ BillableSpecificity Drives DRG and HCC Accuracy
Tip
Always cross-reference the radiology report and neurology consult notes before finalizing I62.9, since these documents frequently contain the anatomical specificity that the admitting H&P lacks, potentially supporting a more precise code assignment from the I61 category.
✅ Includes
- Cerebral hemorrhage not otherwise specified as to cause or location, used when documentation simply states “intracerebral hemorrhage” or “cerebral bleed.”
- Hemorrhagic cerebrovascular accident (CVA) where imaging confirms parenchymal bleeding but no specific lobe or structure is documented.
- Spontaneous (nontraumatic) brain hemorrhage occurring in the setting of uncontrolled hypertension, anticoagulant therapy, or unspecified vascular fragility.
- Apoplexy of hemorrhagic type, an older clinical term sometimes still used in documentation to describe sudden-onset intracerebral bleeding.
- Massive intracerebral hemorrhage with midline shift when the specific lobar or subcortical location is not documented in the final report.
❌ Excludes
Excludes 1
S06.36xx — Traumatic intracerebral hemorrhage with loss of consciousness is mutually exclusive with I62.9 because the presence of any documented trauma, including falls or head strikes preceding the bleed, redirects coding to Chapter 19 injury codes rather than the circulatory system chapter. I60.9 — Nontraumatic subarachnoid hemorrhage, unspecified, is mutually exclusive because it describes bleeding into the subarachnoid space surrounding the brain rather than within the brain parenchyma itself, representing a distinct anatomical compartment with different clinical management pathways.
Danger
The most common Excludes 1 error occurs when a patient has a documented fall or head injury concurrent with an intracerebral hemorrhage, and the coder assigns I62.9 without reviewing whether the trauma was the precipitating cause; in such cases, an S06 code is required instead, and failure to query can result in a significant DRG and severity misclassification.
Excludes 2
I69.1- — Sequelae of nontraumatic intracerebral hemorrhage may be coded together with I62.9 only in the rare circumstance where a patient is admitted with a new acute intracerebral hemorrhage while also having documented residual deficits, such as hemiplegia, from a prior unrelated hemorrhagic stroke event; in this scenario both the acute event and the historical sequela are clinically relevant and separately reportable.
📋 Clinical Overview
Hemorrhagic vs. Ischemic Stroke Differentiation
The single most critical clinical distinction for accurate I62.9 assignment is confirming via imaging that the stroke is hemorrhagic rather than ischemic, since the two etiologies require entirely different ICD-10-CM code families, different DRG groupings, and carry markedly different treatment protocols and prognoses.
| Feature | I62.9 | I61.9 | I63.9 |
|---|---|---|---|
| Anatomical Location | Bleeding into brain parenchyma at an unspecified or undetermined site, distinguishing it from bleeds with known lobar or subcortical localization. | Bleeding into brain parenchyma where the hemisphere is unspecified but is more clinically characterized as intracerebral hemorrhage proper rather than the catch-all “other” category. | Represents cerebral infarction (ischemic stroke) due to unspecified occlusion or stenosis, an entirely different pathophysiology involving tissue death from lack of blood flow rather than bleeding. |
| Typical Presentation | Sudden severe headache, rapid neurological decline, often with elevated blood pressure at presentation and CT showing hyperdense blood without specified location documented. | Similar acute presentation but documentation specifically identifies the event as intracerebral (within brain tissue) hemorrhage without hemisphere laterality. | Gradual or sudden onset of focal neurological deficits, often without headache, with CT or MRI showing hypodense areas consistent with infarcted tissue rather than blood. |
| DRG and Treatment Pathway | Groups to DRG 064-066 (Intracranial Hemorrhage or Cerebral Infarction), with management focused on blood pressure control, reversal of anticoagulation if present, and possible surgical evacuation. | Also groups to DRG 064-066, with similar hemorrhage-focused management protocols including neurosurgical consultation for possible decompression. | Also groups to DRG 064-066, but treatment pathway diverges significantly toward thrombolytics or thrombectomy if within the appropriate time window, which would be contraindicated in hemorrhagic stroke. |
Important
A major CDI trigger for I62.9 is any documentation that mentions anticoagulant or antiplatelet therapy at admission, since reversal agents administered (such as vitamin K, prothrombin complex concentrate, or idarucizumab) may need to be captured as additional procedures or diagnoses affecting both the clinical picture and resource utilization reflected in the DRG.
Manifestations & Symptom Burden
Hemiparesis or hemiplegia frequently accompanies intracerebral hemorrhage and should be coded separately using the appropriate G81 or I69 code depending on whether it represents an acute deficit or a sequela. Altered level of consciousness, ranging from lethargy to coma, is common with larger hemorrhages and may warrant additional coding if it meets clinical significance criteria and is separately evaluated. Aphasia or dysarthria often results from hemorrhages affecting language-dominant hemispheres and should be captured with the relevant R47 series code when documented as a distinct condition requiring evaluation. Dysphagia is a frequent complication requiring swallow evaluation and may justify additional resource-intensive interventions reflected in the chart. Seizure activity can occur as a direct manifestation of the hemorrhage and, if documented, should be coded separately as it may represent a CC depending on payer-specific logic.
Tip
When coding manifestations of I62.9, always verify that the documentation explicitly links the symptom to the hemorrhagic event or independently meets MEAT criteria for separate reporting, since symptoms that are simply part of the expected clinical picture of a stroke without distinct evaluation or treatment may not warrant separate code assignment under certain payer audit standards.
💰 HCC Risk Adjustment
ICD-10 CM I62.9 maps to HCC 112 under the CMS-HCC V28 model as part of the Cerebral Hemorrhage hierarchical condition category, reflecting the substantial clinical complexity and resource utilization associated with hemorrhagic stroke care. This HCC carries a meaningfully elevated RAF weight compared to many chronic condition HCCs, reflecting the acute, high-acuity nature of the diagnosis. For Medicare Advantage risk adjustment purposes, I62.9 must be documented and coded at least once per calendar year if the condition remains clinically relevant, though in practice acute intracerebral hemorrhage is typically captured during the inpatient admission itself rather than requiring ongoing annual capture for an acute, resolved event. Providers should be aware that if a patient’s hemorrhage resolves and they transition to a sequela state, the applicable I69.1- sequela code would map to a different HCC (typically HCC 100-103 depending on the resulting deficit), and continued use of I62.9 in subsequent encounters would be inappropriate and could trigger an audit flag for inconsistent coding.
🏥 MS-DRG Assignment
| DRG | Title | Relative Weight Consideration |
|---|---|---|
| DRG 064 | Intracranial Hemorrhage or Cerebral Infarction with MCC | Highest weight; requires a qualifying MCC such as acute respiratory failure (J96.0-) or severe sepsis (A41.9 with R65.20) |
| DRG 065 | Intracranial Hemorrhage or Cerebral Infarction with CC | Mid-level weight; requires a qualifying CC such as acute kidney injury (N17.9) |
| DRG 066 | Intracranial Hemorrhage or Cerebral Infarction without CC/MCC | Lowest weight; assigned when no CC or MCC is documented or coded |
When I62.9 is sequenced as the principal diagnosis, the DRG ultimately assigned depends entirely on the presence of secondary diagnoses meeting CC or MCC criteria, making thorough chart review for comorbidities such as encephalopathy, respiratory failure, or sepsis essential for accurate severity capture. A frequent inpatient coding pitfall is under-coding secondary conditions present on admission that would elevate the DRG from 066 to 065 or 064, resulting in reimbursement that does not reflect the true resource intensity of the stay. Coders should also confirm that any procedures performed, such as ventriculostomy or craniotomy for hematoma evacuation, do not actually shift the case into a surgical MDC 01 DRG pathway (such as DRG 020-023 for craniotomy procedures) rather than the medical DRG 064-066 family.
🔗 Related ICD-10-CM Codes
Other Hemorrhagic Stroke Codes: I61.0, I61.1, I61.9, I60.9, I62.1
Related Manifestation and Sequela Codes: R47.01, R29.818, G81.94, I69.10, I69.151
🛠️ Commonly Associated CPT Codes
- 70450 — CT head/brain without contrast is the primary imaging study used to confirm and characterize an acute intracerebral hemorrhage and is almost universally performed on admission for suspected stroke.
- 70460 — CT head/brain with contrast may be performed if vascular malformation or tumor-related hemorrhage is suspected, requiring additional documentation to support medical necessity.
- 70551 — MRI brain without contrast is often used for further characterization once the patient is stabilized, particularly to evaluate for underlying lesions.
- 61154 — Burr hole craniotomy for evacuation of hematoma may be performed for larger hemorrhages causing significant mass effect, and if performed would shift DRG assignment to a surgical pathway.
- 99291 — Critical care, first 30-74 minutes, is frequently billed for the initial management of acute intracerebral hemorrhage patients requiring intensive monitoring and intervention.
- 96374 — IV push of a single drug may be reported when reversal agents for anticoagulation are administered emergently.
NCCI Bundling Considerations
CT imaging codes such as 70450 are generally not bundled with evaluation and management or critical care codes, as imaging interpretation is considered separately reportable from cognitive services. However, multiple CT studies performed on the same date without distinct medical necessity documentation may face bundling edits or require modifier -59 to indicate a separately identifiable service. Procedural codes like 61154 carry significant NCCI edits with E/M services on the same day due to global surgical package rules, requiring careful modifier application if separately billable services are rendered.
🔬 ICD-10-PCS Crosswalk
- 00940ZZ — Drainage of cerebral ventricle, open approach, would be reported if a ventriculostomy or external ventricular drain is placed to manage elevated intracranial pressure resulting from the hemorrhage.
- 00980ZZ — Drainage of cerebral hemisphere, open approach, applies when a craniotomy is performed specifically to evacuate the intracerebral hematoma itself.
- 3E0G3GC — Introduction of nutritional substance into upper GI via natural or artificial opening, may apply if a feeding tube is placed due to dysphagia resulting from the hemorrhage’s neurological impact.
💊 Coding Scenarios and Examples
Scenario 1: A 72-year-old male with a history of hypertension presents with sudden left-sided weakness and altered mental status. CT head shows a large right-sided intracerebral hemorrhage; the radiology report does not specify the exact lobe involved, and the attending’s final documentation simply states “intracerebral hemorrhage.” During the stay, the patient develops acute respiratory failure requiring BiPAP. Correct coding: I62.9, J96.00, G81.94 Sequencing explanation: I62.9 is sequenced as principal diagnosis since it represents the condition responsible for admission; J96.00 (acute respiratory failure, unspecified) qualifies as an MCC, driving assignment to DRG 064; G81.94 (hemiplegia, unspecified affecting left side) captures the neurological deficit. CDI note: A CDI query could be issued to radiology or the attending to determine if a more specific anatomical location can be documented, potentially supporting an I61 code with greater specificity for risk adjustment purposes.
Scenario 2: A 65-year-old female on warfarin for atrial fibrillation presents with sudden headache and hemiparesis. CT confirms intracerebral hemorrhage without specified location; INR is supratherapeutic at 4.5, and the patient receives vitamin K and fresh frozen plasma. No CC/MCC conditions are otherwise documented. Correct coding: I62.9, D68.32, I48.91 Sequencing explanation: I62.9 is principal diagnosis; D68.32 (hemorrhagic disorder due to anticoagulants) is coded as an additional diagnosis reflecting the anticoagulant-associated etiology and may serve as a CC;I48.91 (atrial fibrillation, unspecified) is coded as the underlying chronic condition prompting anticoagulant use. CDI note: Query to confirm whether D68.32 should be sequenced or whether the documentation supports this as the etiology, since proper capture of the anticoagulant-associated bleeding code can affect CC status and DRG assignment from 066 to 065.
Scenario 3: A 58-year-old patient is admitted with intracerebral hemorrhage, unspecified location, and during the stay develops acute kidney injury with creatinine rising from 1.0 to 2.3, documented and treated with IV fluids and nephrology consultation. Correct coding: I62.9, N17.9 Sequencing explanation: I62.9 remains principal diagnosis; N17.9 (acute kidney injury, unspecified) is coded as a secondary diagnosis qualifying as a CC, supporting assignment to DRG 065 rather than DRG 066. CDI note: No additional query needed if AKI is clearly documented with supporting lab values and treatment, as this meets MEAT criteria for separate code capture.
⚠️ Coding Pitfalls and Tips
A frequent pitfall is defaulting to I62.9 when the radiology report actually specifies an anatomical location such as the basal ganglia or thalamus, in which case a more specific code from the I61 category should be assigned instead, and failure to do so can understate clinical specificity for quality and risk adjustment reporting. Another common error involves assigning I62.9 when documentation reveals a recent fall or head trauma preceding the hemorrhage, which would instead require a code from the S06 series under Excludes1 rules, and missing this distinction can result in significant DRG misclassification. Coders should always review for documented hemiplegia or hemiparesis and assign the appropriate G81 code when the deficit is present at the time of the encounter, as failing to capture this can understate severity. When anticoagulant-associated hemorrhage is suspected based on home medication lists showing warfarin or a DOAC, coders should query for D68.32 if not explicitly linked, since this can be a significant CC affecting DRG assignment. Coders must also distinguish between an acute I62.9 event and a sequela using I69.1- codes, as continuing to use I62.9 for a resolved, historical hemorrhage with residual deficits is a sequencing error that misrepresents the encounter type. Finally, when surgical intervention such as 61154 (burr hole craniotomy) is performed, the case typically reclassifies to a surgical DRG within MDC 01 rather than remaining in the medical DRG 064-066 family, and coders should verify the correct MDC and DRG pathway based on the highest-ranking procedure performed.
1, 2, 3, 4, 5, 6 1. CMS, ICD-10-CM Official Guidelines for Coding and Reporting, FY2026
2. CMS, ICD-10-CM Tabular List of Diseases and Injuries, FY2026 (I60-I69)
3. CMS, MS-DRG Definitions Manual, Version 43 (FY2026), MDC 01
4. CMS-HCC Risk Adjustment Model, Version 28 (V28) Mapping, 2026
5. AHA Coding Clinic for ICD-10-CM/PCS, relevant guidance on intracerebral hemorrhage specificity
6. AMA CPT Professional Edition, 2026, Radiology and Surgery sections