Is ICD-10-CM code P91 billable?

No, P91 (Other disturbances of cerebral status 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 P91 belong to?

P91 belongs to Chapter 16 of the ICD-10-CM tabular list: P00–P96 (Certain Conditions Originating in the Perinatal Period).

P91Not billable, use a more specific code below

Other disturbances of cerebral status of newborn

In Other disorders originating in the perinatal period (P90-P96), chapter 16: Certain Conditions Originating in the Perinatal Period

18 billable codes under P91: 11 are an MCC, 3 are a CC; all map to HCC 202 (Coma, Brain Compression/Anoxic Damage), HCC 249 (Ischemic or Unspecified Stroke).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.

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 P91

P91 can't be used on a claim. Pick a billable code below; grey headings group them.

P91 MS-DRGs

As the principal diagnosis, the billable codes under P91 group to MS-DRG 791, 793, 794, 091, 092, or 093 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 791 Prematurity with Major Problems (16 of 18 codes)
DRG 793 Full Term Neonate with Major Problems (16 of 18 codes)
DRG 794 Neonate with Other Significant Problems (2 of 18 codes)
DRG 091 Other Disorders of Nervous System with MCC (1 of 18 codes)
DRG 092 Other Disorders of Nervous System with CC (1 of 18 codes)
DRG 093 Other Disorders of Nervous System without CC/MCC (1 of 18 codes)

About the condition

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

Brain Diseases

Your brain is the control center of your body. It controls your thoughts, memory, speech, and movement. It regulates the function of many organs. It's part of your nervous system, which also includes your spinal cord and peripheral nerves. The nervous system sends signals between your brain and the rest of the body. Your nerves take in information from your senses and send it to the brain to be processed. Your brain and nerves also communicate to help you move and to control your body's functions.

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.