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P23 ICD-10-CM Code: Congenital pneumonia

ICD-10-CM Code View

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FY 2026 Apr update / Certain conditions originating in the perinatal period (P00-P96) / Respiratory and cardiovascular disorders specific to the perinatal period (P19-P29)

P23

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

Congenital pneumonia

Congenital pneumonia

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
P2Respiratory and cardiovascular disorders specific to the perinatal period (P19-P29)
P23Congenital pneumonia

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for P23 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for P23 in this effective period.

Related Child Codes

Official
P23.0Congenital pneumonia due to viral agent
P23.1Congenital pneumonia due to Chlamydia
P23.2Congenital pneumonia due to staphylococcus
P23.3Congenital pneumonia due to streptococcus, group B
P23.4Congenital pneumonia due to Escherichia coli

Includes

Official
  • infective pneumonia acquired in utero or during birth

Excludes 1

Official
  • neonatal pneumonia resulting from aspiration (P24.-)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for P23 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for P23 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for P23 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

P23 is the ICD-10-CM diagnosis code for congenital pneumonia. P23 sits in the ICD-10-CM chapter for certain conditions originating in the perinatal period (p00-p96), within the section covering respiratory and cardiovascular disorders specific to the perinatal period (p19-p29).

Header codes like P23 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 P23'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 P23 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • infective pneumonia acquired in utero or during birth

Excludes 1, Do NOT code together

  • neonatal pneumonia resulting from aspiration (P24.-)

Child Codes

Code Hierarchy

P23Congenital pneumonia
P23Congenital pneumonia

Work P23 in HCC Buddy

Open P23 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 14 days to try everything.