Is P07.1 a billable ICD-10-CM code?

No. P07.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does P07.1 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).

What cannot be coded together with P07.1?

P07.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

P07.1

P07.1 — Other low birth weight newborn

Non-billable headerICD-10-CM

P07.1 is a non-billable header ICD-10-CM code for other low birth weight newborn. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

low birth weight due to slow fetal growth and fetal malnutrition (P05.-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Newborn birth weight 1000-2499 g.

Risk adjustment

P07.1 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.

Code to one of these instead P07.1

6 child codes. Green means billable.

Related codes at this level

Codes that share P07. If P07.1 is not quite right, the correct code is usually one of these.

Questions about P07.1

Is P07.1 a billable ICD-10-CM code?: No. P07.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does P07.1 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).
What cannot be coded together with P07.1?: P07.1 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.