P96 ICD-10-CM Code: Other conditions originating in the perinatal period
P96 is not a CMS-HCC payment code. 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)
P96
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceOther conditions originating in the perinatal period
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
OfficialNo inclusion terms are included in this display for P96. 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
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
OfficialNo Excludes 1 notes are included in this display for P96. Check the code and parent instructions in the Code Book.
Code First
OfficialNo Code First sequencing instructions are included in this display for P96. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for P96. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for P96. Check the code and parent instructions in the Code Book.
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 →
- Code
- P96
- Description
- Other conditions originating in the perinatal period
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- No
- Payment year
- 2026
Coder workflow notes
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What This Code Means
P96 is the ICD-10-CM diagnosis code for other conditions originating in the perinatal period. P96 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).
Header codes like P96 cannot be reported on claims directly; they organize child codes that share clinical context. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for P96 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.