P07.31 ICD-10-CM Code: Preterm newborn, gestational age 28 completed weeks
HCC Buddy Code Card
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FY 2026 Apr update / Certain conditions originating in the perinatal period (P00-P96) / Disorders of newborn related to length of gestation and fetal growth (P05-P08)
P07.31
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePreterm newborn, gestational age 28 completed weeks
A newborn born at 28 completed weeks of pregnancy, representing the beginning of the preterm category with improved prognosis compared to extremely premature infants.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
MappedHCC 245
Varies by metal level
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Preterm newborn, gestational age 28 weeks, 0 days through 28 weeks, 6 days
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for P07.31 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for P07.31 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for P07.31 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for P07.31 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for P07.31 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for P07.31 in this effective period.
Buddy Documentation Tip
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 →
Is P07.31 an HCC code?
No. P07.31 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- P07.31
- Description
- Preterm newborn, gestational age 28 completed weeks
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
P07.31 is the ICD-10-CM diagnosis code for preterm newborn, gestational age 28 completed weeks. A newborn born at 28 completed weeks of pregnancy, representing the beginning of the preterm category with improved prognosis compared to extremely premature infants. P07.31 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).
P07.31 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 marks the transition from 'extreme immaturity' to 'preterm' classification; ensure correct code selection based on gestational age.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for P07.31 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This marks the transition from 'extreme immaturity' to 'preterm' classification; ensure correct code selection based on gestational age
- •Document any complications and interventions specific to 28-week gestation infants