Question 1

What is ICD-10 code P00.2?

Accepted Answer

P00.2 is the ICD-10-CM diagnosis code for Newborn affected by maternal infectious and parasitic diseases. A newborn baby who has been affected by the mother's infectious or parasitic disease during pregnancy. The baby may have acquired infection in utero or experienced complications from maternal illness. P00.2 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. P00.2 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Question 2

Is P00.2 an HCC code?

Accepted Answer

No. P00.2 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is P00.2 billable?

Accepted Answer

Yes. P00.2 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. P00.2 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

What is the V28 vs V24 difference for P00.2?

Accepted Answer

P00.2 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards P00.2 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting P00.2?

Accepted Answer

This is a perinatal code for the newborn; specify the actual infectious disease with additional codes (P35-P39 for congenital infections) Document whether infection was transmitted to the fetus or if effects are from maternal illness only

P00.2

Is P00.2 an HCC code?

What This Code Means

Coding Tips

Excludes 1 — Do NOT code together

Excludes 2 — Not included here, may code separately

Code Hierarchy

Open P00.2 in the Interactive Encoder