P91.5
P91.5: Neonatal coma
Billable / specific codeICD-10-CM
P91.5 is a billable, specific ICD-10-CM code for neonatal coma. It is valid for submission on a claim.
Check P91.5 with the rest of the claim: free scrubberOther codes that can never be billed with P91.5
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
P91.5 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
P91.5 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
- Coma›newborn
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under P91
- P91.0Neonatal cerebral ischemia
- P91.1Acquired periventricular cysts of newborn
- P91.2Neonatal cerebral leukomalacia
- P91.3Neonatal cerebral irritability
- P91.4Neonatal cerebral depression
- P91.6Hypoxic ischemic encephalopathy [HIE]
- P91.8Other specified disturbances of cerebral status of newborn
- P91.9Disturbance of cerebral status of newborn, unspecified