2027 ICD-10-CM Diagnosis Code P23.0Congenital pneumonia due to viral agent
ICD-10-CM Codes›P00–P96›P19-P29›P23
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Not Chronic
P23.0 is a billable ICD-10-CM diagnosis code for congenital pneumonia due to viral agent. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 791, 793. 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 68 closely related codes. Coders also document this condition as congenital pneumonia. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Perinatal infections, Respiratory perinatal condition, and Viral infection.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Congenital pneumonia
- Congenital viral pneumonia
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to P23.0: its own notes plus those printed at P23 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.
- infective pneumonia acquired in utero or during birth
- 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
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- congenital rubella pneumonitis (P35.0)
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.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code (B97) to identify organism
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 P23.0, its category, or a range that includes it.
Excludes1 3
These codes carry an Excludes1 note naming P23.0: they are not reported together with it, unless the two conditions are unrelated.
- J18 Pneumonia, unspecified organismcongenital pneumonia (P23.0)
- J15 Bacterial pneumonia, not elsewhere classifiedcongenital pneumonia (P23.-) names P23.-, which includes this code
- J16 Pneumonia due to other infectious organisms, not elsewhere classifiedcongenital pneumonia (P23.-) names P23.-, which includes this code
Excludes2 2
These codes carry an Excludes2 note naming P23.0: its condition is not part of those codes, and both may be reported when the patient has both.
- J12 Viral pneumonia, not elsewhere classifiedcongenital pneumonia (P23.0)
- Block P35-P39 Infections specific to the perinatal periodcongenital pneumonia (P23.-) names P23.-, which includes this code
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
Pneumonia
Pneumonia is an infection in one or both of your lungs. It causes the air sacs of your lungs to fill up with fluid or pus. Pneumonia can range from mild to severe, depending on what caused it, your age, and your overall health.
The full article covers:
- What is pneumonia?
- What causes pneumonia?
- Who is more likely to develop pneumonia?
- What are the symptoms of pneumonia?
- What other problems can pneumonia cause?
- How is pneumonia diagnosed?
- What are the treatments for pneumonia?
- Can pneumonia be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert P23.0 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About P23.0Overview
What is the ICD-10 code for congenital pneumonia due to viral agent?
The ICD-10-CM code for congenital pneumonia due to viral agent is P23.0 (sometimes written as P230). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is P23.0 (Congenital pneumonia) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report congenital pneumonia due to viral agent on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does P23.0 group to?
When congenital pneumonia due to viral agent is the principal diagnosis on an inpatient stay, it groups to MS-DRG 793, 791, with relative weights from 4.1073 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.
Is P23.0 a CC or MCC?
CMS lists P23.0 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 68 closely related codes in its exclusion list.
Can P23.0 be reported with P35.0?
Not as a rule. The Excludes1 note on P23.0 lists "congenital rubella pneumonitis (P35.0)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
