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P36.3 ICD-10-CM Code: Sepsis of newborn due to other and unspecified staphylococci

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FY 2026 Apr update / Certain conditions originating in the perinatal period (P00-P96) / Infections specific to the perinatal period (P35-P39)

P36.3

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

Sepsis of newborn due to other and unspecified staphylococci

Sepsis of newborn due to other and unspecified staphylococci

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
P36Bacterial sepsis of newborn
P36.3Sepsis of newborn due to other and unspecified staphylococci

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for P36.3 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for P36.3 in this effective period.

Related Child Codes

Official
P36.30Sepsis of newborn due to unspecified staphylococci
P36.39Sepsis of newborn due to other staphylococci

Includes

Official
  • congenital sepsis

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for P36.3 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for P36.3 in this effective period.

Use Additional

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

Code Also

Official

ICD-10-CM does not list Code Also instructions for P36.3 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

P36.3 is the ICD-10-CM diagnosis code for sepsis of newborn due to other and unspecified staphylococci. P36.3 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 P36.3 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 P36.3'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 P36.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

P36Bacterial sepsis of newbornP36.3Sepsis of newborn due to other and unspecified staphylococci
P36.3Sepsis of newborn due to other and unspecified staphylococci

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