ICD-10 P74.0
Billable / Specific MCCLate metabolic acidosis of newborn
About ICD-10-CM P74.0
ICD-10-CM code P74.0 represents Late metabolic acidosis of newborn. This is a billable/specific code in the Perinatal Period chapter (block P74). The 2026 edition of ICD-10-CM P74.0 became effective on October 1, 2025.
Coding Tips for P74.0
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
P74.0 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.
Type 1 Excludes
Pure excludes, these codes can never be coded together with P74.0. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- (fetal) metabolic acidosis of newborn (P19)
Inpatient DRG Impact, MCC
codes Late metabolic acidosis of newborn. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for P74.0
Local Coverage Determinations (LCDs) from CMS MACs that list P74.0 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 P74.0.
1 Cigna
CPT Codes Commonly Billed with P74.0
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 P74.0 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 |
|---|---|---|
| P74.0 | 7757 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To P74.0
Other codes in section P70-P74 (Transitory endocrine and metabolic disorders specific to newborn).
ICD-10 P74.0, Billing FAQ
Is ICD-10 code P74.0 billable? +
Yes, P74.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What codes are Type 1 Excludes for P74.0? +
Type 1 Excludes (never code together with P74.0): (fetal) metabolic acidosis of newborn (P19)
Is P74.0 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 P74.0 map to? +
Per CMS GEMs, P74.0 maps to ICD-9 codes: 7757. 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 June 1, 2026.
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