Is P26.1 a billable ICD-10-CM code?

Yes. P26.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does P26.1 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).

What cannot be coded together with P26.1?

P26.1 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 P26.1 (P26) and apply to it just the same.

P26.1

P26.1 — Massive pulmonary hemorrhage originating in the perinatal period

Billable / specific codeICD-10-CM

P26.1 is a billable, specific ICD-10-CM code for massive pulmonary hemorrhage originating in the perinatal period. It is valid for submission on a claim.

Excludes1 inherited from the categories above P26.1

These are not written on P26.1, but they bind it: a note on a category applies to every code beneath it. Billing P26.1 with anything listed here is a denial.

Written on P26 — Pulmonary hemorrhage originating in the perinatal period

acute idiopathic hemorrhage in infants over 28 days old (R04.81)

Other codes that can never be billed with P26.1

These codes carry an Excludes1 note pointing at P26.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading P26.1 alone.

R04.81Acute idiopathic pulmonary hemorrhage in infants
P54Other neonatal hemorrhages

Risk adjustment

P26.1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 213 Cardio-Respiratory Failure and Shock0.370 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

How P26.1 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 P26.1.

Hemorrhage, hemorrhagic›lung›newborn›massive
Hemorrhage, hemorrhagic›pulmonary›newborn›massive

Code history

P26.1 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 P26. If P26.1 is not quite right, the correct code is usually one of these.

Questions about P26.1

Is P26.1 a billable ICD-10-CM code?: Yes. P26.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does P26.1 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).
What cannot be coded together with P26.1?: P26.1 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 P26.1 (P26) and apply to it just the same.