P02.9
BillableNewborn affected by abnormality of membranes, unspecified
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is P02.9 an HCC code?
No. P02.9 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
P02.9 is the ICD-10-CM diagnosis code for newborn affected by abnormality of membranes, unspecified. A newborn baby is affected by a problem with the membranes during pregnancy or delivery, but the specific type of abnormality is not documented. P02.9 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).
P02.9 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 an unspecified code; use only when the specific membrane abnormality cannot be determined from documentation.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for P02.9 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is an unspecified code; use only when the specific membrane abnormality cannot be determined from documentation
- •Query the provider if more specific membrane abnormality information is available in the medical record