P29.81
BillableCardiac arrest of newborn
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is P29.81 an HCC code?
Yes. P29.81 maps to Cardio-Respiratory Failure and Shock under the CMS-HCC V28 risk adjustment model.
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for P29.81
For P29.81to 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 P29.81 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
P29.81 is the ICD-10-CM diagnosis code for cardiac arrest of newborn. A newborn's heart stops beating, requiring immediate resuscitation and emergency intervention. P29.81 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, P29.81 maps to Cardio-Respiratory Failure and Shock (HCC 213) with a community, non-dual, aged base RAF weight of 0.000. P29.81 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.
Document the cause of arrest (asphyxia, sepsis, congenital heart disease, etc.) if identified. Because P29.81 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 P29.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the cause of arrest (asphyxia, sepsis, congenital heart disease, etc.) if identified
- •Code the underlying condition in addition to this code to capture the complete clinical picture
Clinical Significance
Cardiac arrest of newborn represents complete cessation of cardiac activity, constituting the most critical cardiovascular emergency in the neonatal period. This condition requires immediate cardiopulmonary resuscitation and carries extremely high mortality risk, with survivors often facing significant neurodevelopmental complications due to hypoxic-ischemic injury.
Documentation Requirements
- ✓Documentation of cardiac arrest event
- ✓CPR and resuscitation efforts provided
- ✓Duration of arrest if known
- ✓Gestational age and birth weight
- ✓Underlying precipitating cause
- ✓Response to resuscitation efforts
- ✓Post-arrest neurological status
- ✓Associated organ dysfunction