P90-P96 — Other disorders originating in the perinatal period
ICD-10-CM codes P90-P96 cover other disorders originating in the perinatal period, within certain conditions originating in the perinatal period. The block holds 58 codes across 7 categories, of which 47 are billable and 11 are header codes that cannot be submitted on a claim.
Risk adjustment in P90-P96
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 202 Coma, Brain Compression/Anoxic Damage
- HCC 137 Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications
- HCC 249 Ischemic or Unspecified Stroke
- HCC 201 Seizure Disorders and Convulsions
What else to watch in P90-P96
- 2 codes are laterality-specific. They come in left and right pairs, and the pair is mutually exclusive on a single site: coding both without a bilateral code is a contradiction a scrubber should catch before the payer does.
- 27 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.