P61.6 ICD-10-CM Code: Other transient neonatal disorders of coagulation
P61.6 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC coding software
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FY 2026 Apr update / Certain conditions originating in the perinatal period (P00-P96) / Hemorrhagic and hematological disorders of newborn (P50-P61)
P61.6
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther transient neonatal disorders of coagulation
Temporary blood clotting problems in newborns that are not classified elsewhere, typically resolving on their own within days or weeks.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
MappedHCC 75
Varies by metal level
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for P61.6 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for P61.6 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for P61.6 in this effective period.
Excludes 1
Official- transient hypogammaglobulinemia of infancy (D80.7)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for P61.6 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for P61.6 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for P61.6 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is P61.6 an HCC code?
No. P61.6 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- P61.6
- Description
- Other transient neonatal disorders of coagulation
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
P61.6 is the ICD-10-CM diagnosis code for other transient neonatal disorders of coagulation. Temporary blood clotting problems in newborns that are not classified elsewhere, typically resolving on their own within days or weeks. P61.6 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).
P61.6 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.
Use this code for transient coagulation disorders specific to the perinatal period that don't fit other P61 subcategories.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for P61.6 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code for transient coagulation disorders specific to the perinatal period that don't fit other P61 subcategories
- •Document the specific type of coagulation disorder when possible to support medical necessity