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P36

Non-Billable (Header)

Bacterial sepsis of newborn

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

What This Code Means

P36 is the ICD-10-CM diagnosis code for bacterial sepsis of newborn. P36 sits in the ICD-10-CM chapter for certain conditions originating in the perinatal period (p00-p96), within the section covering infections specific to the perinatal period (p35-p39).

Header codes like P36 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 P36'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 P36 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • congenital sepsis

Use Additional Code

  • code(s), if applicable, to identify severe sepsis (R65.2-) and associated acute organ dysfunction(s)

Child Codes

Code Hierarchy

P36Bacterial sepsis of newborn
P36Bacterial sepsis of newborn

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