P37.1 — Congenital toxoplasmosis
P37.1 is a billable, specific ICD-10-CM code for congenital toxoplasmosis. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Hydrocephalus due to congenital toxoplasmosis
Other codes that can never be billed with P37.1
These codes carry an Excludes1 note pointing at P37.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading P37.1 alone.
Risk adjustment
P37.1 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.
Medicare coverage
P37.1 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57204Billing and Coding: MRI and CT Scans of the Head and Neck
How P37.1 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 P37.1.
- 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
Related codes at this level
Codes that share P37. If P37.1 is not quite right, the correct code is usually one of these.
Questions about P37.1
- Is P37.1 a billable ICD-10-CM code?
- Yes. P37.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does P37.1 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).