Is P03.811 a billable ICD-10-CM code?

Yes. P03.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does P03.811 sit in the tabular list?

Certain conditions originating in the perinatal period (P00-P96), in the block Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery (P00-P04).

What cannot be coded together with P03.811?

P03.811 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above P03.811 (P03.81) and apply to it just the same.

P03.811

P03.811 — Newborn affected by abnormality in fetal (intrauterine) heart rate or rhythm during labor

Billable / specific codeICD-10-CM

P03.811 is a billable, specific ICD-10-CM code for newborn affected by abnormality in fetal (intrauterine) heart rate or rhythm during labor. It is valid for submission on a claim.

Excludes1 inherited from the categories above P03.811

These are not written on P03.811, but they bind it: a note on a category applies to every code beneath it. Billing P03.811 with anything listed here is a denial.

Written on P03.81 — Newborn affected by abnormality in fetal (intrauterine) heart rate or rhythm

neonatal cardiac dysrhythmia (P29.1-)

Excludes2 inherited from the categories above P03.811

Also inherited, and the opposite of Excludes1: these conditions are not part of P03.811, but a patient can have both, so you may code both.

Written on P03 — Newborn affected by other complications of labor and delivery

encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)

Other codes that can never be billed with P03.811

These codes carry an Excludes1 note pointing at P03.811. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading P03.811 alone.

P00.7Newborn affected by other medical procedures on mother, not elsewhere classified

Risk adjustment

P03.811 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

P03.811 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A57189Billing and Coding: Serum Magnesium
A59186Billing and Coding: Magnesium

How P03.811 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to P03.811.

Arrhythmia›newborn›occurring before birth›during labor
Dysrhythmia›cardiac›newborn›occurring before birth›during labor
Newborn›affected by›heart rate abnormalities›intrauterine›during labor

Code history

P03.811 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share P03.81. If P03.811 is not quite right, the correct code is usually one of these.

Questions about P03.811

Is P03.811 a billable ICD-10-CM code?: Yes. P03.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does P03.811 sit in the tabular list?: Certain conditions originating in the perinatal period (P00-P96), in the block Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery (P00-P04).
What cannot be coded together with P03.811?: P03.811 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above P03.811 (P03.81) and apply to it just the same.