ICD-10 P07.0
Non-Billable HeaderExtremely low birth weight newborn
About ICD-10-CM P07.0
ICD-10-CM code P07.0 represents Extremely low birth weight newborn. This is a non-billable header code in the Perinatal Period chapter (block P07). The 2026 edition of ICD-10-CM P07.0 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under P07.0. Per CMS ICD-10-CM Tabular 2026.
- Newborn birth weight 999 g. or less
Type 1 Excludes
Pure excludes, these codes can never be coded together with P07.0. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- low birth weight due to slow fetal growth and fetal malnutrition (P05.-)
Medicare LCD Coverage for P07.0
Local Coverage Determinations (LCDs) from CMS MACs that list P07.0 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 P07.0.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but P07.0 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with P07.0
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 P07.0
Other codes in section P05-P08 (Disorders of newborn related to length of gestation and fetal growth).
ICD-10 P07.0, Billing FAQ
Is ICD-10 code P07.0 billable? +
No, P07.0 is a non-billable header code. Use a more specific child code from block P07 when submitting claims.
What other names or terms map to P07.0? +
ICD-10 P07.0 includes: Newborn birth weight 999 g. or less.
What codes are Type 1 Excludes for P07.0? +
Type 1 Excludes (never code together with P07.0): low birth weight due to slow fetal growth and fetal malnutrition (P05.-)
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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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