Is ICD-10-CM code P38 billable?

No, P38 (Omphalitis 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 P38 belong to?

P38 belongs to Chapter 16 of the ICD-10-CM tabular list: P00–P96 (Certain Conditions Originating in the Perinatal Period).

P38Not billable, use a more specific code below

Omphalitis of newborn

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

2 billable codes under P38: all are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.

Instructional notes

Excludes1: not coded here, use a different code

omphalitis not of newborn (L08.82)
tetanus omphalitis (A33)
umbilical hemorrhage of newborn (P51.-)

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 P38.

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.

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 P38

P38 can't be used on a claim. Pick a billable code below; grey headings group them.

P38 MS-DRGs

As the principal diagnosis, all 2 billable codes under P38 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 P38

Notes on these codes point to P38.

L02.2 Excludes1: omphalitis of newborn (P38.-)
L03.31 Excludes2: omphalitis of newborn (P38.-)
L08.82 Excludes1: omphalitis of newborn (P38.-)

About the condition

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

Uncommon Infant and Newborn Problems

It can be scary when your baby is sick, especially when it is not an everyday problem like a cold or a fever. You may not know whether the problem is serious or how to treat it. If you have concerns about your baby's health, call your health care provider right away.

Code history

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