P07.14
BillableOther low birth weight newborn, 1000-1249 grams
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is P07.14 an HCC code?
No. P07.14 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
P07.14 is the ICD-10-CM diagnosis code for other low birth weight newborn, 1000-1249 grams. A newborn baby weighing between 1000-1249 grams (about 2.2-2.75 pounds) at birth, classified as low birth weight and requiring close medical monitoring. P07.14 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).
P07.14 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.
Ensure birth weight documentation clearly falls within this 250-gram range to avoid miscoding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for P07.14 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Ensure birth weight documentation clearly falls within this 250-gram range to avoid miscoding
- •This weight range typically indicates need for special care nursery or NICU level services