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

ICD-10 P37.8

Billable / Specific MCC

Other specified congenital infectious and parasitic diseases

P37
Block
0
Synonyms
28
LCDs
1
Payer Policies
0
Linked CPTs

About ICD-10-CM P37.8

ICD-10-CM code P37.8 represents Other specified congenital infectious and parasitic diseases. This is a billable/specific code in the Perinatal Period chapter (block P37). The 2026 edition of ICD-10-CM P37.8 became effective on October 1, 2025.

Coding Tips for P37.8

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

Inpatient DRG impact: MCC

P37.8 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inpatient DRG Impact, MCC

codes Other specified congenital infectious and parasitic diseases. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.

Medicare LCD Coverage for P37.8

Local Coverage Determinations (LCDs) from CMS MACs that list P37.8 as a covered diagnosis.

28 LCDs

Showing top 10 of 28 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck
Article ID: 57204, Effective: 2025-10-23 00:00:00, 6455 covered, 0 non-covered
CPT 70553 →
CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck
Article ID: 57204, Effective: 2025-10-23 00:00:00, 6455 covered, 0 non-covered
CPT 70336 →
CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck
Article ID: 57204, Effective: 2025-10-23 00:00:00, 6455 covered, 0 non-covered
CPT 72142 →
CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck
Article ID: 57204, Effective: 2025-10-23 00:00:00, 6455 covered, 0 non-covered
CPT 70450 →
CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck
Article ID: 57204, Effective: 2025-10-23 00:00:00, 6455 covered, 0 non-covered
CPT 72127 →
CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck
Article ID: 57204, Effective: 2025-10-23 00:00:00, 6455 covered, 0 non-covered
CPT 70551 →
CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck
Article ID: 57204, Effective: 2025-10-23 00:00:00, 6455 covered, 0 non-covered
CPT 70543 →
CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck
Article ID: 57204, Effective: 2025-10-23 00:00:00, 6455 covered, 0 non-covered
CPT 70482 →
CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck
Article ID: 57204, Effective: 2025-10-23 00:00:00, 6455 covered, 0 non-covered
CPT 72126 →
CMS LCD: Billing and Coding: MRI and CT Scans of the Head and Neck
Article ID: 57204, Effective: 2025-10-23 00:00:00, 6455 covered, 0 non-covered
CPT 70558 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing P37.8.

1 policies

1 Medicare

Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204

CPT Codes Commonly Billed with P37.8

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

No procedure linkages on file for P37.8

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 P37.8 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
P37.8 7712 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 P37.8, Billing FAQ

Is ICD-10 code P37.8 billable? +

Yes, P37.8 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is P37.8 a CC or MCC for inpatient DRG? +

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

What ICD-9 codes does P37.8 map to? +

Per CMS GEMs, P37.8 maps to ICD-9 codes: 7712. 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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