ICD-10 · PDGM grouping
P00-P04 — Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery
Every ICD-10-CM code in this range and the PDGM clinical group CMS assigns to it, read from the CMS grouper crosswalk v07.2.26.
ICD-10-CM FY2027 · CMS grouper v07.2.26
Codes in range
70
No clinical group
15
A period cannot be grouped from these.
Barred as primary
0
CMS rejects these in the primary position.
Where these codes group
55 of the 70 codes in P00-P04 group to MMTA - Other. A further 15 are assigned no clinical group at all, which means a 30-day period cannot be grouped from them.
Code families in P00-P04
One page per three-character family: every code in it, whether it can lead a claim, its clinical group and comorbidity subgroup.
- P00Newborn affected by maternal conditions that may be unrelated to present pregnancy12 codes
- P01Newborn affected by maternal complications of pregnancy10 codes
- P02Newborn affected by complications of placenta, cord and membranes13 codes
- P03Newborn affected by other complications of labor and delivery13 codes
- P04Newborn affected by noxious substances transmitted via placenta or breast milk22 codes
Every code in P00-P04
Descriptions are CMS’s own, abbreviated as CMS abbreviates them.
| Code | Description | Clinical group | Primary position |
|---|---|---|---|
| P000 | Newborn affected by maternal hypertensive disorders | A | Can lead a claim, code first applies |
| P001 | Newborn aff by maternal renal and urinary tract diseases | A | Can lead a claim, code first applies |
| P002 | Newborn affected by maternal infec/parastc diseases | A | Can lead a claim, code first applies |
| P003 | Newborn affected by other maternal circ and resp diseases | A | Can lead a claim, code first applies |
| P004 | Newborn affected by maternal nutritional disorders | A | Can lead a claim, code first applies |
| P005 | Newborn affected by maternal injury | A | Can lead a claim, code first applies |
| P006 | Newborn affected by surgical procedure on mother | A | Can lead a claim, code first applies |
| P007 | Newborn affected by other medical procedures on mother, NEC | A | Can lead a claim, code first applies |
| P0081 | Newborn affected by periodontal disease in mother | A | Can lead a claim, code first applies |
| P0082 | NB aff by (positive) matern group B strep (GBS) colonization | None | Cannot lead a claim |
| P0089 | Newborn affected by other maternal conditions | A | Can lead a claim, code first applies |
| P009 | Newborn affected by unspecified maternal condition | None | Cannot lead a claim |
| P010 | Newborn affected by incompetent cervix | A | Can lead a claim, code first applies |
| P011 | Newborn affected by premature rupture of membranes | A | Can lead a claim, code first applies |
| P012 | Newborn affected by oligohydramnios | A | Can lead a claim, code first applies |
| P013 | Newborn affected by polyhydramnios | A | Can lead a claim, code first applies |
| P014 | Newborn affected by ectopic pregnancy | A | Can lead a claim, code first applies |
| P015 | Newborn affected by multiple pregnancy | A | Can lead a claim, code first applies |
| P016 | Newborn affected by maternal death | A | Can lead a claim, code first applies |
| P017 | Newborn affected by malpresentation before labor | A | Can lead a claim, code first applies |
| P018 | Newborn affected by other maternal comp of pregnancy | A | Can lead a claim, code first applies |
| P019 | Newborn affected by maternal comp of pregnancy, unspecified | A | Can lead a claim, code first applies |
| P020 | Newborn affected by placenta previa | A | Can lead a claim, code first applies |
| P021 | Newborn affected by oth placental separation and hemorrhage | A | Can lead a claim, code first applies |
| P0220 | Newborn aff by unsp morpholog and functn abnlt of placenta | A | Can lead a claim, code first applies |
| P0229 | Newborn aff by other morpholog and functn abnlt of placenta | A | Can lead a claim, code first applies |
| P023 | Newborn affected by placental transfusion syndromes | A | Can lead a claim, code first applies |
| P024 | Newborn affected by prolapsed cord | A | Can lead a claim, code first applies |
| P025 | Newborn affected by other compression of umbilical cord | A | Can lead a claim, code first applies |
| P0260 | Newborn affected by unspecified conditions of umbilical cord | A | Can lead a claim, code first applies |
| P0269 | Newborn affected by other conditions of umbilical cord | A | Can lead a claim, code first applies |
| P0270 | Newborn affected by fetal inflammatory response syndrome | A | Can lead a claim, code first applies |
| P0278 | Newborn affected by other conditions from chorioamnionitis | A | Can lead a claim, code first applies |
| P028 | Newborn affected by other abnormalities of membranes | A | Can lead a claim, code first applies |
| P029 | Newborn affected by abnormality of membranes, unspecified | A | Can lead a claim, code first applies |
| P030 | Newborn affected by breech delivery and extraction | A | Can lead a claim, code first applies |
| P031 | NB aff by oth malpresent, malpos & disproprtn dur labr & del | A | Can lead a claim, code first applies |
| P032 | Newborn affected by forceps delivery | A | Can lead a claim, code first applies |
| P033 | Newborn affected by delivery by vacuum extractor [ventouse] | A | Can lead a claim, code first applies |
| P034 | Newborn affected by Cesarean delivery | A | Can lead a claim, code first applies |
| P035 | Newborn affected by precipitate delivery | A | Can lead a claim, code first applies |
| P036 | Newborn affected by abnormal uterine contractions | A | Can lead a claim, code first applies |
| P03810 | NB aff by abnlt in fetal heart rate or rhym bef onset labor | A | Can lead a claim, code first applies |
| P03811 | NB aff by abnlt in fetal heart rate or rhythm during labor | A | Can lead a claim, code first applies |
| P03819 | NB aff by abnlt in fetal heart rate or rhym, unsp time onset | A | Can lead a claim, code first applies |
| P0382 | Meconium passage during delivery | A | Can lead a claim, code first applies |
| P0389 | Newborn affected by oth complications of labor and delivery | A | Can lead a claim, code first applies |
| P039 | Newborn affected by comp of labor and delivery, unspecified | None | Cannot lead a claim |
| P040 | NB aff by matern anesth and analgesia in preg, labor and del | None | Cannot lead a claim |
| P0411 | Newborn affected by maternal antineoplastic chemotherapy | A | Can lead a claim, code first applies |
| P0412 | Newborn affected by maternal cytotoxic drugs | A | Can lead a claim, code first applies |
| P0413 | Newborn affected by maternal use of anticonvulsants | A | Can lead a claim, code first applies |
| P0414 | Newborn affected by maternal use of opiates | A | Can lead a claim, code first applies |
| P0415 | Newborn affected by maternal use of antidepressants | A | Can lead a claim, code first applies |
| P0416 | Newborn affected by maternal use of amphetamines | A | Can lead a claim, code first applies |
| P0417 | Newborn affected by maternal use of sedative-hypnotics | A | Can lead a claim, code first applies |
| P0418 | Newborn affected by other maternal medication | A | Can lead a claim, code first applies |
| P0419 | Newborn affected by maternal use of unspecified medication | A | Can lead a claim, code first applies |
| P041A | Newborn affected by maternal use of anxiolytics | A | Can lead a claim, code first applies |
| P042 | Newborn affected by maternal use of tobacco | None | Cannot lead a claim |
| P043 | Newborn affected by maternal use of alcohol | None | Cannot lead a claim |
| P0440 | Newborn affected by maternal use of unsp drugs of addiction | None | Cannot lead a claim |
| P0441 | Newborn affected by maternal use of cocaine | None | Cannot lead a claim |
| P0442 | Newborn affected by maternal use of hallucinogens | None | Cannot lead a claim |
| P0449 | Newborn affected by maternal use of other drugs of addiction | None | Cannot lead a claim |
| P045 | Newborn aff by maternal use of nutritional chemical substnc | None | Cannot lead a claim |
| P046 | Newborn aff by maternal exposure to environ chemical substnc | None | Cannot lead a claim |
| P0481 | Newborn affected by maternal use of cannabis | None | Cannot lead a claim |
| P0489 | Newborn affected by other maternal noxious substances | None | Cannot lead a claim |
| P049 | Newborn affected by maternal noxious substance, unspecified | None | Cannot lead a claim |
Source: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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