ICD-10 P08.1
Billable / SpecificOther heavy for gestational age newborn
About ICD-10-CM P08.1
ICD-10-CM code P08.1 represents Other heavy for gestational age newborn. This is a billable/specific code in the Perinatal Period chapter (block P08). The 2026 edition of ICD-10-CM P08.1 became effective on October 1, 2025.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under P08.1. Per CMS ICD-10-CM Tabular 2026.
- Other newborn heavy- or large-for-dates regardless of period of gestation
- Usually implies a birth weight of 4000 g. to 4499 g.
Type 1 Excludes
Pure excludes, these codes can never be coded together with P08.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- newborn with a birth weight of 4500 or more (P08.0)
- syndrome of infant of diabetic mother (P70.1)
- syndrome of infant of mother with gestational diabetes (P70.0)
Medicare LCD Coverage for P08.1
Local Coverage Determinations (LCDs) from CMS MACs that list P08.1 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 P08.1.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but P08.1 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with P08.1
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.
Convert P08.1 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| P08.1 | 7661 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To P08.1
Other codes in section P05-P08 (Disorders of newborn related to length of gestation and fetal growth).
ICD-10 P08.1, Billing FAQ
Is ICD-10 code P08.1 billable? +
Yes, P08.1 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 P08.1? +
ICD-10 P08.1 includes: Other newborn heavy- or large-for-dates regardless of period of gestation; Usually implies a birth weight of 4000 g. to 4499 g..
What codes are Type 1 Excludes for P08.1? +
Type 1 Excludes (never code together with P08.1): newborn with a birth weight of 4500 or more (P08.0); syndrome of infant of diabetic mother (P70.1); syndrome of infant of mother with gestational diabetes (P70.0)
What ICD-9 codes does P08.1 map to? +
Per CMS GEMs, P08.1 maps to ICD-9 codes: 7661. 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 May 31, 2026.
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