Is ICD-10-CM code P78 billable?

No, P78 (Other perinatal digestive system 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 P78 belong to?

P78 belongs to Chapter 16 of the ICD-10-CM tabular list: P00–P96 (Certain Conditions Originating in the Perinatal Period).

P78Not billable, use a more specific code below

Other perinatal digestive system disorders

In Digestive system disorders of newborn (P76-P78), chapter 16: Certain Conditions Originating in the Perinatal Period

10 billable codes under P78: 1 is an MCC; 1 map to HCC 78 (Intestinal Obstruction/Perforation).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

cystic fibrosis (E84.0-E84.9)
neonatal gastrointestinal hemorrhages (P54.0-P54.3)

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 P78

P78 can't be used on a claim. Pick a billable code below; grey headings group them.

P78 MS-DRGs

As the principal diagnosis, the billable codes under P78 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 (9 of 10 codes)
DRG 791 Prematurity with Major Problems (1 of 10 codes)
DRG 793 Full Term Neonate with Major Problems (1 of 10 codes)

About the condition

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

Digestive Diseases

When you eat, your body breaks food down to a form it can use to build and nourish cells and provide energy. This process is called digestion. Your digestive system is a series of hollow organs joined in a long, twisting tube. It runs from your mouth to your anus and includes your esophagus, stomach, and small and large intestines. Your liver, gallbladder and pancreas are also involved. They produce juices to help digestion.

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.