Is P36.5 a billable ICD-10-CM code?

Yes. P36.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does P36.5 sit in the tabular list?

Certain conditions originating in the perinatal period (P00-P96), in the block Infections specific to the perinatal period (P35-P39).

P36.5

P36.5 — Sepsis of newborn due to anaerobes

Billable / specific codeICD-10-CM

P36.5 is a billable, specific ICD-10-CM code for sepsis of newborn due to anaerobes. It is valid for submission on a claim.

Other codes that can never be billed with P36.5

These codes carry an Excludes1 note pointing at P36.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading P36.5 alone.

A41Other sepsis

Risk adjustment

P36.5 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock0.500 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.

Medicare coverage

P36.5 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
A57224Billing and Coding: Respiratory Care

How P36.5 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 P36.5.

Newborn›sepsis›due to›anaerobes NEC
Sepsis›newborn›due to›anaerobes NEC

Code history

P36.5 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 P36. If P36.5 is not quite right, the correct code is usually one of these.

Questions about P36.5

Is P36.5 a billable ICD-10-CM code?: Yes. P36.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does P36.5 sit in the tabular list?: Certain conditions originating in the perinatal period (P00-P96), in the block Infections specific to the perinatal period (P35-P39).