P90 ICD-10-CM Code: Convulsions of newborn
P90 maps to CMS-HCC V28 201. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Certain conditions originating in the perinatal period (P00-P96) / Other disorders originating in the perinatal period (P90-P96)
P90
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceConvulsions of newborn
Seizures or convulsive episodes occurring in newborns, which may be caused by various conditions such as infection, metabolic issues, or birth trauma.
Buddy Insight
Neonatal convulsions represent serious neurological complications requiring immediate evaluation and treatment.
CMS-HCC V28
MappedHCC 201
Coefficient HCC 201: 0.245 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 120
Code-level coefficient reference
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for P90. Check the code and parent instructions in the Code Book.
Excludes 2
Official- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from P00-P96
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from P00-P96
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from P00-P96
- neoplasms (C00-D49)Inherited from P00-P96
- tetanus neonatorum (A33)Inherited from P00-P96
Related Codes
No related codes are included in this display for P90. Check the Code Book for the complete code path.
Includes
Official- conditions that have their origin in the fetal or perinatal period (before birth through the first 28 days after birth) even if morbidity occurs laterInherited from P00-P96
Excludes 1
Official- benign myoclonic epilepsy in infancy (G40.3-)
- benign neonatal convulsions (familial) (G40.3-)
Code First
OfficialNo Code First sequencing instructions are included in this display for P90. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for P90. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for P90. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 P90 an HCC code?
Yes. P90 (Convulsions of newborn) maps to HCC 201, Seizure Disorders and Convulsions under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.245. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: P90 is billable and maps to V28 HCC 201, Seizure Disorders and Convulsions. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- P90
- Description
- Convulsions of newborn
- HCC (V28)
- HCC 201 — Seizure Disorders and Convulsions
- RAF reference coefficient
- 0.245
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work P90 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for P90
For P90, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Coder workflow notes
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What This Code Means
P90 is the ICD-10-CM diagnosis code for convulsions of newborn. Seizures or convulsive episodes occurring in newborns, which may be caused by various conditions such as infection, metabolic issues, or birth trauma. P90 sits in the ICD-10-CM chapter for certain conditions originating in the perinatal period (p00-p96), within the section covering other disorders originating in the perinatal period (p90-p96).
Under the CMS-HCC V28 risk adjustment model, P90 maps to Seizure Disorders and Convulsions (HCC 201) with a source-labeled community, non-dual, aged reference coefficient of 0.245. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Always investigate and document the underlying cause of neonatal seizures, as this may require additional coding. For P90, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for P90 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Always investigate and document the underlying cause of neonatal seizures, as this may require additional coding
- •Distinguish between true seizures and benign sleep myoclonus or jitteriness, which are not coded as convulsions
Clinical Significance
Neonatal convulsions represent serious neurological complications requiring immediate evaluation and treatment. This diagnosis indicates significant risk for developmental delays, cerebral palsy, and long-term neurological sequelae affecting the infant's prognosis.
Documentation Requirements
- ✓Clear documentation of seizure activity or convulsions in newborn
- ✓Description of seizure type and characteristics observed
- ✓EEG findings if performed to confirm seizure activity
- ✓Underlying etiology identified (hypoxia, infection, metabolic, etc.)
- ✓Response to anticonvulsant therapy if administered
- ✓Neurological examination findings
- ✓Associated complications such as respiratory compromise
- ✓Follow-up neurological assessments and outcomes