P28.5 — Respiratory failure of newborn
P28.5 is a billable, specific ICD-10-CM code for respiratory failure of newborn. It is valid for submission on a claim.
Other codes that can never be billed with P28.5
These codes carry an Excludes1 note pointing at P28.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading P28.5 alone.
Risk adjustment
P28.5 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 P28.5 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 P28.5.
- Failure, failed›respiration, respiratory›newborn
- Inadequate, inadequacy›pulmonary›ventilation, newborn
- Insufficiency, insufficient›respiratory›newborn
- Respiration›insufficient, or poor›newborn
- Inadequate, inadequacy›pulmonary›function›newborn
Related codes at this level
Codes that share P28. If P28.5 is not quite right, the correct code is usually one of these.
Questions about P28.5
- Is P28.5 a billable ICD-10-CM code?
- Yes. P28.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does P28.5 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).