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P00

Non-Billable (Header)

Newborn affected by maternal conditions that may be unrelated to present pregnancy

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

What This Code Means

P00 is the ICD-10-CM diagnosis code for newborn affected by maternal conditions that may be unrelated to present pregnancy. P00 sits in the ICD-10-CM chapter for certain conditions originating in the perinatal period (p00-p96), within the section covering newborn affected by maternal factors and by complications of pregnancy, labor, and delivery (p00-p04).

Header codes like P00 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at P00's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for P00 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 2 — Not included here, may code separately

  • 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 First

  • any current condition in newborn

Child Codes

Code Hierarchy

P00Newborn affected by maternal conditions that may be unrelated to present pregnancy
P00Newborn affected by maternal conditions that may be unrelated to present pregnancy

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