Is P23.6 a billable ICD-10-CM code?

Yes. P23.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does P23.6 sit in the tabular list?

Certain conditions originating in the perinatal period (P00-P96), in the block Respiratory and cardiovascular disorders specific to the perinatal period (P19-P29).

P23.6

P23.6 — Congenital pneumonia due to other bacterial agents

Billable / specific codeICD-10-CM

P23.6 is a billable, specific ICD-10-CM code for congenital pneumonia due to other bacterial agents. It is valid for submission on a claim.

Use additional code

Add a secondary code to capture the detail described below.

code (B95-B96) to identify organism

Inclusion terms

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

Congenital pneumonia due to Hemophilus influenzae
Congenital pneumonia due to Klebsiella pneumoniae
Congenital pneumonia due to Mycoplasma
Congenital pneumonia due to Streptococcus, except group B

Other codes that can never be billed with P23.6

These codes carry an Excludes1 note pointing at P23.6. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading P23.6 alone.

J13Pneumonia due to Streptococcus pneumoniae
J14Pneumonia due to Hemophilus influenzae

Risk adjustment

P23.6 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 P23.6 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 P23.6.

Pneumonia›congenital›due to›bacterium NEC
Pneumonia›congenital›due to›Haemophilus influenzae
Pneumonia›congenital›due to›Klebsiella pneumoniae
Pneumonia›congenital›due to›Mycoplasma
Pneumonia›congenital›due to›Streptococcus(except group B)

Related codes at this level

Codes that share P23. If P23.6 is not quite right, the correct code is usually one of these.

Questions about P23.6

Is P23.6 a billable ICD-10-CM code?: Yes. P23.6 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does P23.6 sit in the tabular list?: Certain conditions originating in the perinatal period (P00-P96), in the block Respiratory and cardiovascular disorders specific to the perinatal period (P19-P29).