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P28 ICD-10-CM Code: Other respiratory conditions originating in the perinatal period

P28 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software

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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)

P28

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

Other respiratory conditions originating in the perinatal period

Other respiratory conditions originating in the perinatal period

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
P2Respiratory and cardiovascular disorders specific to the perinatal period (P19-P29)
P28Other respiratory conditions originating in the perinatal period

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for P28 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for P28 in this effective period.

Related Child Codes

Official
P28.0Primary atelectasis of newborn
P28.1Other and unspecified atelectasis of newborn
P28.2Cyanotic attacks of newborn
P28.3Primary sleep apnea of newborn
P28.4Other apnea of newborn

Includes

Official

ICD-10-CM does not list Includes notes for P28 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for P28 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for P28 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for P28 in this effective period.

Code Also

Official
  • , if applicable, congenital malformations of the respiratory system (Q30-Q34)

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
P28
Description
Other respiratory conditions originating in the perinatal period
HCC (V28)
No CMS-HCC V28 mapping
RAF
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

P28 is the ICD-10-CM diagnosis code for other respiratory conditions originating in the perinatal period. P28 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 P28 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 P28'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 P28 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Code Also

  • , if applicable, congenital malformations of the respiratory system (Q30-Q34)

Child Codes

Code Hierarchy

P28Other respiratory conditions originating in the perinatal period
P28Other respiratory conditions originating in the perinatal period

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