2026 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 2026 (October 1, 2025 through September 30, 2026) 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
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Use Additional Code
- code B97
Type 1 Excludes
- congenital rubella pneumonitis P35.0
The “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
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, 2025 through September 30, 2026.
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, 2025 through September 30, 2026.
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 791, 793, with relative weights from 4.0590 to 4.1696 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 2026. 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.
What is the ICD-9 equivalent of P23.0?
Under the General Equivalence Mappings, congenital pneumonia due to viral agent converts to ICD-9-CM 770.0 (congenital pneumonia). The mapping is approximate, so confirm the match fits the documentation.
