Question 1

What is ICD-10 code P60?

Accepted Answer

P60 is the ICD-10-CM diagnosis code for disseminated intravascular coagulation of newborn. A serious bleeding disorder in newborns where blood clots form throughout the body and use up clotting factors, leading to severe bleeding. P60 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).

P60 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 is a critical condition requiring immediate documentation of the underlying cause (infection, trauma, etc.).

Question 2

Is P60 an HCC code?

Accepted Answer

No. P60 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 P60 billable?

Accepted Answer

Yes. P60 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. P60 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 P60?

Accepted Answer

P60 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 P60 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 P60?

Accepted Answer

This is a critical condition requiring immediate documentation of the underlying cause (infection, trauma, etc.) Coordinate coding with laboratory findings showing prolonged PT/PTT and low platelet counts

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P60

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P60 ICD-10-CM Code: Disseminated intravascular coagulation of newborn

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P60

Is P60 an HCC code?

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What This Code Means

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