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P09 ICD-10-CM Code: Abnormal findings on neonatal screening

P09 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) / Abnormal findings on neonatal screening (P09)

P09

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

Abnormal findings on neonatal screening

Abnormal findings on neonatal screening

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
P0Abnormal findings on neonatal screening (P09)
P09Abnormal findings on neonatal screening

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for P09 in this effective period.

Excludes 2

Official
  • nonspecific serologic evidence of human immunodeficiency virus [HIV] (R75)

Related Child Codes

Official
P09.1Abnormal findings on neonatal screening for inborn errors of metabolism
P09.2Abnormal findings on neonatal screening for congenital endocrine disease
P09.3Abnormal findings on neonatal screening for congenital hematologic disorders
P09.4Abnormal findings on neonatal screening for cystic fibrosis
P09.5Abnormal findings on neonatal screening for critical congenital heart disease

Includes

Official
  • Abnormal findings on state mandated newborn screens
  • Failed newborn screening

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for P09 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for P09 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for P09 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for P09 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
P09
Description
Abnormal findings on neonatal screening
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

P09 is the ICD-10-CM diagnosis code for abnormal findings on neonatal screening. P09 sits in the ICD-10-CM chapter for certain conditions originating in the perinatal period (p00-p96), within the section covering abnormal findings on neonatal screening (p09).

Header codes like P09 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 P09'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 P09 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • Abnormal findings on state mandated newborn screens
  • Failed newborn screening

Excludes 2, Not included here, may code separately

  • nonspecific serologic evidence of human immunodeficiency virus [HIV] (R75)

Child Codes

Code Hierarchy

P09Abnormal findings on neonatal screening
P09Abnormal findings on neonatal screening

P09 code history

Code setChange
FY2022 (effective Oct 1, 2021)Billability changed (now non-billable header)

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

Work P09 in HCC Buddy

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