P05.19
BillableNewborn small for gestational age, other
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is P05.19 an HCC code?
No. P05.19 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
P05.19 is the ICD-10-CM diagnosis code for newborn small for gestational age, other. A newborn who is smaller than expected for their gestational age but does not fit into the other specified weight categories. P05.19 sits in the ICD-10-CM chapter for certain conditions originating in the perinatal period (p00-p96), within the section covering disorders of newborn related to length of gestation and fetal growth (p05-p08).
P05.19 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.
Use this code when small for gestational age is documented but birth weight does not fall into the 750-2499 gram ranges.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for P05.19 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when small for gestational age is documented but birth weight does not fall into the 750-2499 gram ranges
- •This is a catch-all code for small for gestational age newborns with atypical or undocumented birth weights