2026 ICD-10-CM Diagnosis Code P09.5Abnormal findings on neonatal screening for critical congenital heart disease

ICD-10-CM Codes›P00–P96›P09›P09

ICD-10-CM P09.5
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

P09.5 is a billable ICD-10-CM diagnosis code for abnormal findings on neonatal screening for critical congenital heart disease. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 947 through 948. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Cardiac and circulatory congenital anomalies and Other specified and unspecified perinatal conditions.

Code Identity

ICD-10-CM Code
P09.5
Billable Status
Yes — Valid for Submission
Code Describes
Abnormal findings on neonatal screening for critical congenital heart disease
Short Description
Abn find on neonatal screen for critical congen heart dis
Parent Code
P09
Abnormal findings on neonatal screening

Code Classification

ChapterP00–P96Certain conditions originating in the perinatal period
SectionP09Abnormal findings on neonatal screening
CategoryP09Abnormal findings on neonatal screening
This CodeP09.5Abnormal findings on neonatal screening for critical congenital heart disease

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Neonatal congenital heart disease screening failure

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Abnormal, abnormality, abnormalities
      • neonatal screening
        • for
          • critical congenital heart disease
    • Failure, failed
      • newborn screening
        • neonatal congenital heart disease

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR MAL001
Cardiac and circulatory congenital anomalies
Default principal diagnosis: inpatient No · outpatient No
CCSR PNL013
Other specified and unspecified perinatal conditions
Default principal diagnosis: inpatient Yes · outpatient Yes

Code History & ChangesHistory

Replacement P09.5 replaces the following previously assigned code(s):

  • P09 - Abnormal findings on neonatal screening
FY 2022AddedAdded to the ICD-10-CM code setEffective October 1, 2021.
FY 2023–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About P09.5Overview

Is P09.5 (Abnormal findings on neonatal screening) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report abnormal findings on neonatal screening for critical congenital heart disease on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does P09.5 group to?

When abnormal findings on neonatal screening for critical congenital heart disease is the principal diagnosis on an inpatient stay, it groups to MS-DRG 947, 948, with relative weights from 0.8005 to 1.2694 depending on complications. Higher weights mean higher Medicare reimbursement.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.