Coding and coverage · ICD-10-CM
Instructional notes
Chapter 16
Excludes2Not included here: the patient may have both; report both when both are present.
Includes
- conditions that have their origin in the fetal or perinatal period (before birth through the first 28 days after birth) even if morbidity occurs later
Notes
- Codes from this chapter are for use on newborn records only, never on maternal records
Section P00-P04
Notes
- These codes are for use when the listed maternal conditions are specified as the cause of confirmed morbidity or potential morbidity which have their origin in the perinatal period (before birth through the first 28 days after birth).
P00
Excludes2Not included here: the patient may have both; report both when both are present.
- encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)
- newborn affected by maternal complications of pregnancy (P01.-)
- newborn affected by maternal endocrine and metabolic disorders (P70-P74)
- newborn affected by noxious substances transmitted via placenta or breast milk (P04.-)
Code firstSequence the underlying condition first.
- any current condition in newborn
Chapter 16: Certain conditions originating in the perinatal period · P00-P04 Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery (P00-P04)
Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.
Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.