Is ICD-10-CM code P72 billable?

No, P72 (Other transitory neonatal endocrine disorders) 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 P72 belong to?

P72 belongs to Chapter 16 of the ICD-10-CM tabular list: P00–P96 (Certain Conditions Originating in the Perinatal Period).

P72Not billable, use a more specific code below

Other transitory neonatal endocrine disorders

In Transitory endocrine and metabolic disorders specific to newborn (P70-P74), chapter 16: Certain Conditions Originating in the Perinatal Period

5 billable codes under P72: 4 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

congenital hypothyroidism with or without goiter (E03.0-E03.1)
dyshormogenetic goiter (E07.1)
dyshormonogenetic goiter (E07.1)
Pendred's syndrome (E07.1)

Also applies, from Transitory endocrine and metabolic disorders specific to newborn (P70-P74)

These notes sit on P70-P74 and apply to every code under it, including P72.

Includes: conditions that are coded here

transitory endocrine and metabolic disturbances caused by the infant's response to maternal endocrine and metabolic factors, or its adjustment to extrauterine environment

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 P72

P72 can't be used on a claim. Pick a billable code below; grey headings group them.

P72 MS-DRGs

As the principal diagnosis, the billable codes under P72 group to MS-DRG 794, 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 794 Neonate with Other Significant Problems (4 of 5 codes)
DRG 791 Prematurity with Major Problems (1 of 5 codes)
DRG 793 Full Term Neonate with Major Problems (1 of 5 codes)

About the condition

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

Endocrine Diseases

Your endocrine system includes eight major glands throughout your body. These glands make hormones. Hormones are chemical messengers. They travel through your bloodstream to tissues or organs. Hormones work slowly and affect body processes from head to toe. These 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.