ICD-10 P28
Non-Billable HeaderOther respiratory conditions originating in the perinatal period
About ICD-10-CM P28
ICD-10-CM code P28 represents Other respiratory conditions originating in the perinatal period. This is a non-billable header code in the Perinatal Period chapter (block P28). The 2026 edition of ICD-10-CM P28 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.
Coding Notes
Code Also
- , if applicable, congenital malformations of the respiratory system (Q30-Q34)
Medicare LCD Coverage for P28
Local Coverage Determinations (LCDs) from CMS MACs that list P28 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 P28.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but P28 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with P28
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 P28
Other codes in section P19-P29 (Respiratory and cardiovascular disorders specific to the perinatal period).
ICD-10 P28, Billing FAQ
Is ICD-10 code P28 billable? +
No, P28 is a non-billable header code. Use a more specific child code from block P28 when submitting claims.
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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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