What is ICD-10 code P26.8?

P26.8 is the ICD-10-CM diagnosis code for Other pulmonary hemorrhages originating in the perinatal period. Other types of bleeding in the lungs of a newborn during the perinatal period not classified as tracheobronchial or massive hemorrhage. P26.8 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. P26.8 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. P26.8 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. P26.8 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does P26.8 map to under V28?

P26.8 maps to CMS-HCC V28 213 (Cardio-Respiratory Failure and Shock). The category number and label come from the CMS-HCC V28 model file for payment year 2026.

What does P26.8 pay in RAF?

P26.8 carries a community, non-dual, aged (CNA) RAF weight of 0.370 under CMS-HCC V28 for payment year 2026. The weight comes from the CMS V28 relative-factor file, not a hand-typed table.

What is the V28 vs V24 difference for P26.8?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. P26.8 is a payment HCC under V28 (Cardio-Respiratory Failure and Shock) but was not retained as a payment HCC under V24. Both models can still appear in legacy data and in payer-specific lookback periods.

2026 ICD-10-CM P26.8: Other pulmonary

P26.8 maps to CMS-HCC V28 213 (RAF 0.370). Documentation must support MEAT. MEAT criteria · RAF calculator · HCC coding software

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Code lookupP26.8Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

P26.8

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Other pulmonary hemorrhages originating in the perinatal period

Other types of bleeding in the lungs of a newborn during the perinatal period not classified as tracheobronchial or massive hemorrhage.

Buddy Insight

Other pulmonary hemorrhages in newborns encompass various bleeding patterns not classified as tracheobronchial or massive hemorrhage.

CMS-HCC V28

Mapped

HCC 213

Cardio-Respiratory Failure an...

RAF 0.370

CMS-HCC V24

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ACA/HHS

Mapped

HCC 127

HHS-HCC 127

Varies by metal level

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

P26Pulmonary hemorrhage originating in the perinatal period

P26.8Other pulmonary hemorrhages originating in the perinatal period

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for P26.8 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for P26.8 in this effective period.

Related Child Codes

Official

P26.0Tracheobronchial hemorrhage originating in the perinatal period

P26.1Massive pulmonary hemorrhage originating in the perinatal period

P26.9Unspecified pulmonary hemorrhage originating in the perinatal period

Includes

Official

ICD-10-CM does not list Includes notes for P26.8 in this effective period.

Excludes 1

Official

acute idiopathic hemorrhage in infants over 28 days old (R04.81)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for P26.8 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for P26.8 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for P26.8 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Specific description of pulmonary hemorrhage type

Confirmation of perinatal period onset

Location and extent of hemorrhage

Gestational age and birth weight

MEAT Support

HCC Buddy guidance

Specific description of pulmonary hemorrhage type

Confirmation of perinatal period onset

Location and extent of hemorrhage

Gestational age and birth weight

Audit Caution

HCC Buddy guidance

Using when hemorrhage is clearly tracheobronchial or massive

Failing to specify the type when documentation allows

Not confirming perinatal period timing

Confusing with unspecified hemorrhage (P26.9)

Common Mistakes

HCC Buddy guidance

P26.0 — Specific tracheobronchial hemorrhage, not other types

P26.1 — Massive pulmonary hemorrhage, more severe presentation

P26.9 — Unspecified pulmonary hemorrhage when type is unknown

J94.2 — Adult hemothorax, not perinatal condition

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 P26.8 an HCC code?

Yes. P26.8 (Other pulmonary hemorrhages originating in the perinatal period) maps to Cardio-Respiratory Failure and Shock under the CMS-HCC V28 risk adjustment model, with a community non-dual aged RAF of 0.370. It is billable for payment year 2026.

Coder answer: P26.8 is billable and maps to V28 HCC 213, Cardio-Respiratory Failure and Shock. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: P26.8
Description: Other pulmonary hemorrhages originating in the perinatal period
HCC (V28): HCC 213 — Cardio-Respiratory Failure and Shock
RAF: 0.370
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 213, Cardio-Respiratory Failure and Shock

0.370

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work P26.8 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for P26.8

For P26.8 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed P26.8 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

P26.8 is the ICD-10-CM diagnosis code for other pulmonary hemorrhages originating in the perinatal period. Other types of bleeding in the lungs of a newborn during the perinatal period not classified as tracheobronchial or massive hemorrhage. P26.8 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).

Under the CMS-HCC V28 risk adjustment model, P26.8 maps to Cardio-Respiratory Failure and Shock (HCC 213) with a community, non-dual, aged base RAF weight of 0.370. P26.8 was not retained as a payment HCC under the older V24 model, so V28 introduced or recategorized it during the 2024–2026 phase-in. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Use this code for pulmonary hemorrhages that don't meet criteria for P26.0 or P26.1. Because P26.8 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for P26.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code for pulmonary hemorrhages that don't meet criteria for P26.0 or P26.1
•Document the location and extent of bleeding to support medical necessity

Clinical Significance

Other pulmonary hemorrhages in newborns encompass various bleeding patterns not classified as tracheobronchial or massive hemorrhage. These conditions require careful monitoring and may indicate underlying pulmonary immaturity, coagulopathy, or other systemic complications in the vulnerable neonatal population.