ICD-10 P07.3
Non-Billable HeaderPreterm [premature] newborn [other]
About ICD-10-CM P07.3
ICD-10-CM code P07.3 represents Preterm [premature] newborn [other]. This is a non-billable header code in the Perinatal Period chapter (block P07). The 2026 edition of ICD-10-CM P07.3 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 P07.3. Per CMS ICD-10-CM Tabular 2026.
- 28 completed weeks or more but less than 37 completed weeks (196 completed days but less than 259 completed days) of gestation.
- Prematurity NOS
Medicare LCD Coverage for P07.3
Local Coverage Determinations (LCDs) from CMS MACs that list P07.3 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 P07.3.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but P07.3 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with P07.3
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 P07.3
Other codes in section P05-P08 (Disorders of newborn related to length of gestation and fetal growth).
ICD-10 P07.3, Billing FAQ
Is ICD-10 code P07.3 billable? +
No, P07.3 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 P07.3? +
ICD-10 P07.3 includes: 28 completed weeks or more but less than 37 completed weeks (196 completed days but less than 259 completed days) of gestation.; Prematurity NOS.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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