P78.81 ICD-10-CM Code: Congenital cirrhosis (of liver)
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Certain conditions originating in the perinatal period (P00-P96) / Digestive system disorders of newborn (P76-P78)
P78.81
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCongenital cirrhosis (of liver)
A rare condition where a newborn is born with liver cirrhosis (scarring and dysfunction of the liver) present from birth.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
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 P78.81 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for P78.81 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for P78.81 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for P78.81 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for P78.81 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for P78.81 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for P78.81 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is P78.81 an HCC code?
No. P78.81 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- P78.81
- Description
- Congenital cirrhosis (of liver)
- 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
P78.81 is the ICD-10-CM diagnosis code for congenital cirrhosis (of liver). A rare condition where a newborn is born with liver cirrhosis (scarring and dysfunction of the liver) present from birth. P78.81 sits in the ICD-10-CM chapter for certain conditions originating in the perinatal period (p00-p96), within the section covering digestive system disorders of newborn (p76-p78).
P78.81 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 congenital condition; document evidence of cirrhosis on imaging or biopsy and confirm it is present at birth, not acquired.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for P78.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a congenital condition; document evidence of cirrhosis on imaging or biopsy and confirm it is present at birth, not acquired
- •Investigate for underlying causes such as intrauterine infections, metabolic disorders, or genetic conditions