2027 ICD-10-CM Diagnosis Code P22.0Respiratory distress syndrome of newborn
ICD-10-CM Codes›P00–P96›P19-P29›P22
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Risk Adjusts — HCC 213
- Not Chronic
P22.0 is a billable ICD-10-CM diagnosis code for respiratory distress syndrome of newborn. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 790. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 78 closely related codes. Coders also document this condition as acute respiratory distress. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Respiratory distress syndrome.
For Medicare Advantage risk adjustment, P22.0 maps to CMS-HCC Category 213 (Cardio-Respiratory Failure and Shock) under the V28 model, adding a risk factor of about 0.370 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
P22.0 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.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Acute respiratory distress
- Acute respiratory distress in newborn with surfactant disorder
- Genetic disorder of surfactant dysfunction
- Neonatal acute respiratory distress
- Neonatal respiratory distress
- Neonatal respiratory distress syndrome
- Respiratory distress
- Respiratory distress in early neonatal period
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to P22.0: its own notes plus those printed at 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.
- Cardiorespiratory distress syndrome of newborn
- Hyaline membrane disease
- Idiopathic respiratory distress syndrome [IRDS or RDS] of newborn
- Pulmonary hypoperfusion syndrome
- Respiratory distress syndrome, type I
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.
Notes
General instructions on how these codes are used.
- 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 P22.0, its category, or a range that includes it.
Excludes1 7
These codes carry an Excludes1 note naming P22.0: they are not reported together with it, unless the two conditions are unrelated.
- J80 Acute respiratory distress syndromerespiratory distress syndrome in newborn (perinatal) (P22.0)
- J96 Respiratory failure, not elsewhere classifiednewborn respiratory distress syndrome (P22.0)
- P28.11 Resorption atelectasis without respiratory distress syndromeresorption atelectasis with respiratory distress syndrome (P22.0)
- R09 Other symptoms and signs involving the circulatory and respiratory systemrespiratory distress syndrome of newborn (P22.0)
- R09.2 Respiratory arrestrespiratory distress of newborn (P22.0)
- R06 Abnormalities of breathingrespiratory distress syndrome of newborn (P22.-) names P22.-, which includes this code
- T71 Asphyxiationrespiratory distress (syndrome) in newborn (P22.-) names P22.-, which includes this code
Excludes2 3
These codes carry an Excludes2 note naming P22.0: its condition is not part of those codes, and both may be reported when the patient has both.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Disease, diseased See Also: Syndrome;
IRDS (type I) P22.0
RDS (newborn) (type I) P22.0
Respiratory See Also: condition;
Syndrome See Also: Disease;
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Lung Diseases
When you breathe, your lungs take in oxygen from the air and deliver it to the bloodstream. The cells in your body need oxygen to work and grow. During a normal day, you breathe nearly 25,000 times. People with lung disease have difficulty breathing. Millions of people in the U.S. have lung disease.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert P22.0 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About P22.0Overview
What is the ICD-10 code for respiratory distress syndrome of newborn?
The ICD-10-CM code for respiratory distress syndrome of newborn is P22.0 (sometimes written as P220). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is P22.0 (Respiratory distress of newborn) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report respiratory distress syndrome of newborn on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does P22.0 group to?
When respiratory distress syndrome of newborn is the principal diagnosis on an inpatient stay, it groups to MS-DRG 790 (extreme Immaturity or Respiratory Distress Syndrome, Neonate), which carries a relative weight of 6.0142. Higher weights mean higher Medicare reimbursement.
Is P22.0 a CC or MCC?
CMS lists P22.0 as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 78 closely related codes in its exclusion list.
What is the ICD-9 equivalent of P22.0?
Under the General Equivalence Mappings, respiratory distress syndrome of newborn converts to ICD-9-CM 769 (respiratory distress syn). The mapping is a direct match.
What HCC is P22.0?
P22.0 (respiratory distress syndrome of newborn) maps to CMS-HCC Category 213 (Cardio-Respiratory Failure and Shock), commonly written as HCC 213, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It does not map to any RxHCC in the Part D prescription drug model.
Does P22.0 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, P22.0 adds a risk adjustment factor of about 0.370 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.258 to 0.662 depending on the payment segment). A more severe related category (HCC 211 and HCC 212) supersedes it when both are reported. See the full factor table on the HCC 213 category page.
