Is ICD-10-CM code P56 billable?

No, P56 (Hydrops fetalis due to hemolytic disease) 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 P56 belong to?

P56 belongs to Chapter 16 of the ICD-10-CM tabular list: P00–P96 (Certain Conditions Originating in the Perinatal Period).

P56Not billable, use a more specific code below

Hydrops fetalis due to hemolytic disease

In Hemorrhagic and hematological disorders of newborn (P50-P61), chapter 16: Certain Conditions Originating in the Perinatal Period

3 billable codes under P56: all are an MCC; all map to HCC 109 (Acquired Hemolytic, Aplastic, and Sideroblastic Anemias).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

Excludes1: not coded here, use a different code

hydrops fetalis NOS (P83.2)

Also applies, from Hemorrhagic and hematological disorders of newborn (P50-P61)

These notes sit on P50-P61 and apply to every code under it, including P56.

Excludes1: not coded here, use a different code

congenital stenosis and stricture of bile ducts (Q44.3)
Crigler-Najjar syndrome (E80.5)
Dubin-Johnson syndrome (E80.6)
Gilbert syndrome (E80.4)
hereditary hemolytic anemias (D55-D58)

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 P56

P56 can't be used on a claim. Pick a billable code below; grey headings group them.

P56 MS-DRGs

As the principal diagnosis, all 3 billable codes under P56 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 P56

Notes on these codes point to P56.

P83 Excludes1: hydrops fetalis due to hemolytic disease (P56.-)

About the condition

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

Edema

Edema means swelling caused by fluid in your body's tissues. It usually occurs in the feet, ankles and legs, but it can involve your entire body. Causes of edema include:

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.