ICD-10 P01
Non-Billable HeaderNewborn affected by maternal complications of pregnancy
About ICD-10-CM P01
ICD-10-CM code P01 represents Newborn affected by maternal complications of pregnancy. This is a non-billable header code in the Perinatal Period chapter (block P01). The 2026 edition of ICD-10-CM P01 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 2 Excludes
Not included here, the excluded code is not part of P01, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)
Coding Notes
Code First
- any current condition in newborn
Medicare LCD Coverage for P01
Local Coverage Determinations (LCDs) from CMS MACs that list P01 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing P01.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but P01 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with P01
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To P01
Other codes in section P00-P04 (Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery).
ICD-10 P01, Billing FAQ
Is ICD-10 code P01 billable? +
No, P01 is a non-billable header code. Use a more specific child code from block P01 when submitting claims.
What codes are Type 2 Excludes for P01? +
Type 2 Excludes (may be coded together when both conditions exist): encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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