P00.1
BillableNewborn affected by maternal renal and urinary tract diseases
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is P00.1 an HCC code?
No. P00.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
P00.1 is the ICD-10-CM diagnosis code for newborn affected by maternal renal and urinary tract diseases. A newborn baby who has been affected by the mother's kidney or urinary tract disease during pregnancy. The baby may have complications related to maternal renal dysfunction or infection. P00.1 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).
P00.1 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
This is a perinatal code for the newborn; do not use for the mother.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for P00.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a perinatal code for the newborn; do not use for the mother
- •Document the specific maternal renal/urinary condition (pyelonephritis, chronic kidney disease, etc.) in the record