P07.38
BillablePreterm newborn, gestational age 35 completed weeks
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is P07.38 an HCC code?
No. P07.38 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
P07.38 is the ICD-10-CM diagnosis code for preterm newborn, gestational age 35 completed weeks. A baby born before 37 weeks of pregnancy, specifically at 35 completed weeks of gestation. These infants are considered late preterm and typically have better outcomes than earlier preterm births. P07.38 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).
P07.38 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.
Distinguish between 35 weeks and 36 weeks as they have separate codes.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for P07.38 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Distinguish between 35 weeks and 36 weeks as they have separate codes
- •Late preterm infants may be discharged sooner but require follow-up monitoring