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

ICD-10 P28.39

Billable / Specific CC

Other primary sleep apnea of newborn

P28
Block
0
Synonyms
63
LCDs
2
Payer Policies
0
Linked CPTs

About ICD-10-CM P28.39

ICD-10-CM code P28.39 represents Other primary sleep apnea of newborn. This is a billable/specific code in the Perinatal Period chapter (block P28). The 2026 edition of ICD-10-CM P28.39 became effective on October 1, 2025.

Coding Tips for P28.39

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

P28.39 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inpatient DRG Impact, CC

codes Other primary sleep apnea of newborn. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for P28.39

Local Coverage Determinations (LCDs) from CMS MACs that list P28.39 as a covered diagnosis.

63 LCDs

Showing top 10 of 63 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT 93320 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT 76376 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT J0461 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT 93306 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT 93325 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT J2785 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT A9700 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT Q9955 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT 93352 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT J3490 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing P28.39.

2 policies

2 Medicare

Billing and Coding: Transthoracic Echocardiography (TTE)
Policy ID: ART-56781
Billing and Coding: Transthoracic Echocardiography (TTE)
Policy ID: ART-57306

CPT Codes Commonly Billed with P28.39

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

No procedure linkages on file for P28.39

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.

ICD-10 P28.39, Billing FAQ

Is ICD-10 code P28.39 billable? +

Yes, P28.39 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is P28.39 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

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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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