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P03 ICD-10-CM Code: Newborn affected by other complications of labor and delivery

P03 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC Buddy coding tools

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FY 2026 Apr update / Certain conditions originating in the perinatal period (P00-P96) / Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery (P00-P04)

P03

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Newborn affected by other complications of labor and delivery

Newborn affected by other complications of labor and delivery

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Code Book Path

Official
P0Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery (P00-P04)
P03Newborn affected by other complications of labor and delivery

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for P03 in this effective period.

Excludes 2

Official
  • encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)

Related Child Codes

Official
P03.0Newborn affected by breech delivery and extraction
P03.1Newborn affected by other malpresentation, malposition and disproportion during labor and delivery
P03.2Newborn affected by forceps delivery
P03.3Newborn affected by delivery by vacuum extractor [ventouse]
P03.4Newborn affected by Cesarean delivery

Includes

Official

ICD-10-CM does not list Includes notes for P03 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for P03 in this effective period.

Code First

Official
  • any current condition in newborn

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for P03 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for P03 in this effective period.

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Code
P03
Description
Newborn affected by other complications of labor and delivery
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

P03 is the ICD-10-CM diagnosis code for newborn affected by other complications of labor and delivery. P03 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 P03 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 P03'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 P03 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.-)

Code First

  • any current condition in newborn

Child Codes

Code Hierarchy

P03Newborn affected by other complications of labor and delivery
P03Newborn affected by other complications of labor and delivery

P03 code history

Code setChange
FY2017 (effective Oct 1, 2016)Description revised

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

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