ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 P05.2

Billable / Specific

Newborn affected by fetal (intrauterine) malnutrition not light or small for gestational age

P05
Block
1
Synonyms
0
LCDs
0
Payer Policies
0
Linked CPTs

About ICD-10-CM P05.2

ICD-10-CM code P05.2 represents Newborn affected by fetal (intrauterine) malnutrition not light or small for gestational age. This is a billable/specific code in the Perinatal Period chapter (block P05). The 2026 edition of ICD-10-CM P05.2 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under P05.2. Per CMS ICD-10-CM Tabular 2026.

  • Infant, not light or small for gestational age, showing signs of fetal malnutrition, such as dry, peeling skin and loss of subcutaneous tissue

Type 1 Excludes

Pure excludes, these codes can never be coded together with P05.2. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • newborn affected by fetal malnutrition with light for gestational age (P05.0-)
  • newborn affected by fetal malnutrition with small for gestational age (P05.1-)

Medicare LCD Coverage for P05.2

Local Coverage Determinations (LCDs) from CMS MACs that list P05.2 as a covered diagnosis.

No Medicare LCDs reference P05.2 as covered

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 P05.2.

No commercial payer policies reference P05.2 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but P05.2 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with P05.2

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

No procedure linkages on file for P05.2

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.

Convert P05.2 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
P05.2 76420 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 P05.2, Billing FAQ

Is ICD-10 code P05.2 billable? +

Yes, P05.2 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to P05.2? +

ICD-10 P05.2 includes: Infant, not light or small for gestational age, showing signs of fetal malnutrition, such as dry, peeling skin and loss of subcutaneous tissue.

What codes are Type 1 Excludes for P05.2? +

Type 1 Excludes (never code together with P05.2): newborn affected by fetal malnutrition with light for gestational age (P05.0-); newborn affected by fetal malnutrition with small for gestational age (P05.1-)

What ICD-9 codes does P05.2 map to? +

Per CMS GEMs, P05.2 maps to ICD-9 codes: 76420. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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