P72.1
BillableTransitory neonatal hyperthyroidism
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is P72.1 an HCC code?
No. P72.1 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
P72.1 is the ICD-10-CM diagnosis code for transitory neonatal hyperthyroidism. A newborn temporarily has elevated thyroid hormone levels, usually due to maternal antibodies or medications, which typically resolves within weeks. P72.1 sits in the ICD-10-CM chapter for certain conditions originating in the perinatal period (p00-p96), within the section covering transitory endocrine and metabolic disorders specific to newborn (p70-p74).
P72.1 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.
Document maternal history of Graves' disease or antithyroid medication use to support this diagnosis.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for P72.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document maternal history of Graves' disease or antithyroid medication use to support this diagnosis
- •Note that this is a transitory condition expected to resolve as maternal factors clear from the newborn's system