Question 1

What is ICD-10 code P53?

Accepted Answer

P53 is the ICD-10-CM diagnosis code for hemorrhagic disease of newborn. A bleeding disorder in newborns caused by vitamin K deficiency, resulting in prolonged bleeding and bruising. P53 sits in the ICD-10-CM chapter for certain conditions originating in the perinatal period (p00-p96), within the section covering hemorrhagic and hematological disorders of newborn (p50-p61).

P53 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

This condition is preventable with vitamin K prophylaxis given at birth; document whether prophylaxis was administered.

Question 2

Is P53 an HCC code?

Accepted Answer

No. P53 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is P53 billable?

Accepted Answer

Yes. P53 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. P53 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.

Question 4

What is the V28 vs V24 difference for P53?

Accepted Answer

P53 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither community model rewards P53 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

Question 5

What should coders know when reporting P53?

Accepted Answer

This condition is preventable with vitamin K prophylaxis given at birth; document whether prophylaxis was administered Hemorrhagic disease of the newborn is distinct from other coagulation disorders and has specific treatment implications

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P53

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P53 ICD-10-CM Code: Hemorrhagic disease of newborn

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P53

Is P53 an HCC code?

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What This Code Means

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