P37.1

P37.1: Congenital toxoplasmosis

Billable / specific codeICD-10-CM

P37.1 is a billable, specific ICD-10-CM code for congenital toxoplasmosis. It is valid for submission on a claim.

Check P37.1 with the rest of the claim: free scrubber

Inclusion terms

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

Hydrocephalus due to congenital toxoplasmosis

Excludes2 inherited from the categories above P37.1

Not part of this code, but both may be coded when both are present.

Written on P37: Other congenital infectious and parasitic diseases

congenital syphilis (A50.-)
infectious neonatal diarrhea (A00-A09)
necrotizing enterocolitis in newborn (P77.-)
noninfectious neonatal diarrhea (P78.3)
ophthalmia neonatorum due to gonococcus (A54.31)
tetanus neonatorum (A33)

Other codes that can never be billed with P37.1

Their own Excludes1 notes name this code, so the conflict is not listed above.

G91.4Hydrocephalus in diseases classified elsewhere
Q03Congenital hydrocephalus
B58Toxoplasmosis

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

P37.1 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A57204Billing and Coding: MRI and CT Scans of the Head and Neck

Alphabetic index entries that lead here

Hydrocephalus›due to toxoplasmosis(congenital)
Microcephalus, microcephalic, microcephaly›due to toxoplasmosis(congenital)
Microphthalmos, microphthalmia›due to toxoplasmosis
Toxoplasma, toxoplasmosis›congenital(acute) (subacute) (chronic)
Toxoplasma, toxoplasmosis›maternal, manifest toxoplasmosis in infant(acute) (subacute) (chronic)
Infection, infected, infective›congenital›toxoplasmosis(acute) (subacute) (chronic)
Lymphadenopathy›due to toxoplasmosis›congenital(acute) (subacute) (chronic)
Uveitis›due to toxoplasmosis›congenital
Chorioretinitis›in›toxoplasmosis›congenital(active)
Encephalitis›in›toxoplasmosis›congenital
Hepatitis›in›toxoplasmosis›congenital(active)
Meningoencephalitis›in›toxoplasmosis›congenital

Code history

Unchanged in every release from FY2024 to FY2027.