ICD-10 P36
Non-Billable HeaderBacterial sepsis of newborn
About ICD-10-CM P36
ICD-10-CM code P36 represents Bacterial sepsis of newborn. This is a non-billable header code in the Perinatal Period chapter (block P36). The 2026 edition of ICD-10-CM P36 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.
Includes
- congenital sepsis
Use Additional Code
When coding P36, also report these additional codes when applicable.
- code(s), if applicable, to identify severe sepsis (R65.2-) and associated acute organ dysfunction(s)
Medicare LCD Coverage for P36
Local Coverage Determinations (LCDs) from CMS MACs that list P36 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 P36.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but P36 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with P36
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 P36
Other codes in section P35-P39 (Infections specific to the perinatal period).
ICD-10 P36, Billing FAQ
Is ICD-10 code P36 billable? +
No, P36 is a non-billable header code. Use a more specific child code from block P36 when submitting claims.
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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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