P35-P39 — Infections specific to the perinatal period
ICD-10-CM codes P35-P39 cover infections specific to the perinatal period, within certain conditions originating in the perinatal period. The block holds 41 codes across 5 categories, of which 34 are billable and 7 are header codes that cannot be submitted on a claim.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- asymptomatic human immunodeficiency virus [HIV] infection status (Z21)
- congenital gonococcal infection (A54.-)
- congenital pneumonia (P23.-)
- congenital syphilis (A50.-)
- human immunodeficiency virus [HIV] disease (B20)
- infant botulism (A48.51)
- infectious diseases not specific to the perinatal period (A00-B99, J09, J10.-)
- intestinal infectious disease (A00-A09)
- laboratory evidence of human immunodeficiency virus [HIV] (R75)
- tetanus neonatorum (A33)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Infections acquired in utero, during birth via the umbilicus, or during the first 28 days after birth
Risk adjustment in P35-P39
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
What else to watch in P35-P39
- 21 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.