Is ICD-10-CM code P36 billable?

No, P36 (Bacterial sepsis of newborn) 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 P36 belong to?

P36 belongs to Chapter 16 of the ICD-10-CM tabular list: P00–P96 (Certain Conditions Originating in the Perinatal Period).

P36Not billable, use a more specific code below

Bacterial sepsis of newborn

In Infections specific to the perinatal period (P35-P39), chapter 16: Certain Conditions Originating in the Perinatal Period

10 billable codes under P36: all are an MCC; all map to HCC 2 (Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock).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.

Instructional notes

Includes: conditions that are coded here

congenital sepsis

Use additional code: add a second code for this, listed after this one

code(s), if applicable, to identify severe sepsis (R65.2-) and associated acute organ dysfunction(s)

Also applies, from Infections specific to the perinatal period (P35-P39)

These notes sit on P35-P39 and apply to every code under it, including P36.

Includes: conditions that are coded here

Infections acquired in utero, during birth via the umbilicus, or during the first 28 days after birth

Excludes2: not included here, code separately if applicable

asymptomatic human immunodeficiency virus [HIV] infection status (Z21)
congenital gonococcal infection (A54.-)
congenital pneumonia (P23.-)
congenital syphilis (A50.-)
human immunodeficiency virus [HIV] disease (B20)
infant botulism (A48.51)
infectious diseases not specific to the perinatal period (A00-B99, J09, J10.-)
intestinal infectious disease (A00-A09)
laboratory evidence of human immunodeficiency virus [HIV] (R75)
tetanus neonatorum (A33)

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.

Section I.C.16.f Bacterial Sepsis of Newborn (page 74), covers P36
Default undocumented newborn sepsis to congenital and assign P36. Add a B96 code only if the P36 code lacks the organism, never B95 or B96 when it includes it. Add R65.2- and organ dysfunction codes if applicable.

All codes under P36

P36 can't be used on a claim. Pick a billable code below; grey headings group them.

P36 MS-DRGs

As the principal diagnosis, all 10 billable codes under P36 group to MS-DRG 791 or 793 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

Other codes that refer to P36

Notes on these codes point to P36.

A41 Excludes1: neonatal (P36.-)

About the condition

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

Bacterial Infections

Bacteria are tiny organisms (living things) that have only one cell. Under a microscope, they look like balls, rods, or spirals. They can be found almost everywhere on Earth. There are lots of bacteria in and on your body. In fact, your body has about 10 times more bacteria cells than human cells.

Sepsis

Sepsis is your body's overactive and extreme response to an infection. Sepsis is a life-threatening medical emergency. Without quick treatment, it can lead to tissue damage, organ failure, and even death.

Code history

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