Is ICD-10-CM code P12 billable?

No, P12 (Birth injury to scalp) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code P12 belong to?

P12 belongs to Chapter 16 of the ICD-10-CM tabular list: P00–P96 (Certain Conditions Originating in the Perinatal Period).

P12Not billable, use a more specific code below

Birth injury to scalp

In Birth trauma (P10-P15), chapter 16: Certain Conditions Originating in the Perinatal Period

8 billable codes under P12: 1 is a CC; 1 map to HCC 399 (Major Head Injury without Loss of Consciousness).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Official coding guidelines

From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.

Coding of conditions that originate from before birth through the 28th day after birth, including newborn record rules, prematurity, low birth weight, sepsis, and stillbirth.

General Perinatal Rules (page 71)
Observation and Evaluation of Newborns for Suspected Conditions not Found (page 73)
Coding Additional Perinatal Diagnoses (page 73)
Prematurity and Fetal Growth Retardation (page 73)
Low birth weight and immaturity status (page 74)
Bacterial Sepsis of Newborn (page 74)
Stillbirth (page 74)
COVID-19 Infection in Newborn (page 74)

Read Section I.C.16 (page 71)

All codes under P12

P12 can't be used on a claim. Pick a billable code below; grey headings group them.

P12 MS-DRGs

As the principal diagnosis, the billable codes under P12 group to MS-DRG 795, 791, or 793 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 795 Normal Newborn (7 of 8 codes)
DRG 791 Prematurity with Major Problems (1 of 8 codes)
DRG 793 Full Term Neonate with Major Problems (1 of 8 codes)

About the condition

Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.

Childbirth Problems

Childbirth is the process of giving birth to a baby. It includes labor and delivery. Usually everything goes well, but problems can happen. They may cause a risk to the mother, baby, or both. Some of the more common childbirth problems include:

Head Injuries

Chances are you've bumped your head before. Often, the injury is minor because your skull is hard and it protects your brain. But other head injuries can be more severe, such as a skull fracture, concussion, or traumatic brain injury.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.