Is P91.6 a billable ICD-10-CM code?

No. P91.6 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does P91.6 sit in the tabular list?

Certain conditions originating in the perinatal period (P00-P96), in the block Other disorders originating in the perinatal period (P90-P96).

What cannot be coded together with P91.6?

P91.6 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

P91.6

P91.6 — Hypoxic ischemic encephalopathy [HIE]

Non-billable headerICD-10-CM

P91.6 is a non-billable header ICD-10-CM code for hypoxic ischemic encephalopathy [hie]. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

Neonatal cerebral depression (P91.4)
Neonatal cerebral irritability (P91.3)
Neonatal coma (P91.5)

Other codes that can never be billed with P91.6

These codes carry an Excludes1 note pointing at P91.6. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading P91.6 alone.

P84Other problems with newborn

Risk adjustment

P91.6 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.

Code to one of these instead P91.6

4 child codes. Green means billable.

Related codes at this level

Codes that share P91. If P91.6 is not quite right, the correct code is usually one of these.

Questions about P91.6

Is P91.6 a billable ICD-10-CM code?: No. P91.6 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does P91.6 sit in the tabular list?: Certain conditions originating in the perinatal period (P00-P96), in the block Other disorders originating in the perinatal period (P90-P96).
What cannot be coded together with P91.6?: P91.6 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.