P58.42
BillableNeonatal jaundice due to drugs or toxins given to newborn
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is P58.42 an HCC code?
No. P58.42 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
P58.42 is the ICD-10-CM diagnosis code for neonatal jaundice due to drugs or toxins given to newborn. Yellowing of a newborn's skin and eyes caused by medications or toxic substances administered directly to the baby after birth. P58.42 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).
P58.42 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.
Clearly document which drug or toxin was given to the newborn and the route of administration.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for P58.42 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Clearly document which drug or toxin was given to the newborn and the route of administration
- •Use this code only when the substance was given to the newborn, not when transmitted from mother