Is P05.04 a billable ICD-10-CM code?

Yes. P05.04 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does P05.04 sit in the tabular list?

Certain conditions originating in the perinatal period (P00-P96), in the block Disorders of newborn related to length of gestation and fetal growth (P05-P08).

P05.04

P05.04 — Newborn light for gestational age, 1000-1249 grams

Billable / specific codeICD-10-CM

P05.04 is a billable, specific ICD-10-CM code for newborn light for gestational age, 1000-1249 grams. It is valid for submission on a claim.

Risk adjustment

P05.04 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.

How P05.04 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 P05.04.

Light-for-dates›with weight of›1000-1249 grams

Related codes at this level

Codes that share P05.0. If P05.04 is not quite right, the correct code is usually one of these.

Questions about P05.04

Is P05.04 a billable ICD-10-CM code?: Yes. P05.04 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does P05.04 sit in the tabular list?: Certain conditions originating in the perinatal period (P00-P96), in the block Disorders of newborn related to length of gestation and fetal growth (P05-P08).