2027 ICD-10-CM Diagnosis Code P02.70Newborn affected by fetal inflammatory response syndrome
ICD-10-CM Codes›P00–P96›P00-P04›P02
- Billable — Valid for Submission
- Risk Adjusts — HCC 2
- Not Chronic
P02.70 is a billable ICD-10-CM diagnosis code for newborn affected by fetal inflammatory response syndrome. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 794. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Newborn affected by maternal conditions or complications of labor/delivery.
For Medicare Advantage risk adjustment, P02.70 maps to CMS-HCC Category 2 (Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock) under the V28 model, adding a risk factor of about 0.500 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
P02.70 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to P02.70: its own notes plus those printed at P02, block P00-P04, and Chapter 16. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- conditions that have their origin in the fetal or perinatal period (before birth through the first 28 days after birth) even if morbidity occurs later
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Newborn affected by FIRS
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)
Code First
The underlying condition named in the note is sequenced before this code.
- any current condition in newborn
Notes
General instructions on how these codes are used.
- These codes are for use when the listed maternal conditions are specified as the cause of confirmed morbidity or potential morbidity which have their origin in the perinatal period (before birth through the first 28 days after birth).
- Codes from this chapter are for use on newborn records only, never on maternal records
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name P02.70, its category, or a range that includes it.
Applicable To 1
These notes mention P02.70.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Uncommon Infant and Newborn Problems
It can be scary when your baby is sick, especially when it is not an everyday problem like a cold or a fever. You may not know whether the problem is serious or how to treat it. If you have concerns about your baby's health, call your health care provider right away.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Code History & ChangesHistory
Replacement P02.70 replaces the following previously assigned code(s):
- P02.7 - Newborn (suspected to be) affected by chorioamnionitis
- P02.7 - Newborn affected by chorioamnionitis
Questions About P02.70Overview
What is the ICD-10 code for newborn affected by fetal inflammatory response syndrome?
The ICD-10-CM code for newborn affected by fetal inflammatory response syndrome is P02.70 (sometimes written as P0270). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is P02.70 (Newborn affected by chorioamnionitis) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report newborn affected by fetal inflammatory response syndrome on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does P02.70 group to?
When newborn affected by fetal inflammatory response syndrome is the principal diagnosis on an inpatient stay, it groups to MS-DRG 794 (neonate with Other Significant Problems), which carries a relative weight of 1.4934. Higher weights mean higher Medicare reimbursement.
What is coded first with P02.70?
The Code First note at P02, which applies to P02.70, reads: any current condition in newborn. When one of these applies, it is sequenced before P02.70.
What HCC is P02.70?
P02.70 (newborn affected by fetal inflammatory response syndrome) maps to CMS-HCC Category 2 (Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock), commonly written as HCC 2, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 2 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.
Does P02.70 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, P02.70 adds a risk adjustment factor of about 0.500 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.447 to 0.780 depending on the payment segment). HCC 2 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 2 category page.
