P91.3

P91.3: Neonatal cerebral irritability

Billable / specific codeICD-10-CM

P91.3 is a billable, specific ICD-10-CM code for neonatal cerebral irritability. It is valid for submission on a claim.

Check P91.3 with the rest of the claim: free scrubber

Other codes that can never be billed with P91.3

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

P91.6Hypoxic ischemic encephalopathy [HIE]
R68.1Nonspecific symptoms peculiar to infancy

Risk adjustment

P91.3 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 202 Coma, Brain Compression/Anoxic Damage0.543 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

P91.3 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

Irritable, irritability›cerebral, in newborn

Code history

Unchanged in every release from FY2024 to FY2027.