2027 ICD-10-CM Diagnosis Code P23.6Congenital pneumonia due to other bacterial agents
ICD-10-CM Codes›P00–P96›P19-P29›P23
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Not Chronic
P23.6 is a billable ICD-10-CM diagnosis code for congenital pneumonia due to other bacterial agents. 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 bacterial pneumonia. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Bacterial infections, Perinatal infections, and Respiratory perinatal condition.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Congenital bacterial pneumonia
- Congenital group A hemolytic streptococcal pneumonia
- Congenital pneumonia
- Infection caused by Enterococcus
- Infection caused by vancomycin resistant Enterococcus
- Pneumonia caused by Enterococcus
- Pneumonia caused by vancomycin resistant Enterococcus
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to P23.6: 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
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.
- Congenital pneumonia due to Hemophilus influenzae
- Congenital pneumonia due to Klebsiella pneumoniae
- Congenital pneumonia due to Mycoplasma
- Congenital pneumonia due to Streptococcus, except group B
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
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.
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 P23.6, its category, or a range that includes it.
Excludes1 4
These codes carry an Excludes1 note naming P23.6: they are not reported together with it, unless the two conditions are unrelated.
- J13 Pneumonia due to Streptococcus pneumoniaecongenital pneumonia due to S. pneumoniae (P23.6)
- J14 Pneumonia due to Hemophilus influenzaecongenital pneumonia due to H. influenzae (P23.6)
- 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 1
These codes carry an Excludes2 note naming P23.6: its condition is not part of those codes, and both may be reported when the patient has both.
- 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
Bacterial Infections
Bacteria are tiny organisms (living things) that have only one cell. Under a microscope, they look like balls, rods, or spirals. They can be found almost everywhere on Earth. There are lots of bacteria in and on your body. In fact, your body has about 10 times more bacteria cells than human cells.
The full article covers:
- What are bacteria?
- How do bacterial infections spread?
- What are the treatments for bacterial infections?
- Can bacterial infections be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert P23.6 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About P23.6Overview
What is the ICD-10 code for congenital pneumonia due to other bacterial agents?
The ICD-10-CM code for congenital pneumonia due to other bacterial agents is P23.6 (sometimes written as P236). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is P23.6 (Congenital pneumonia) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report congenital pneumonia due to other bacterial agents on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does P23.6 group to?
When congenital pneumonia due to other bacterial agents 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 P23.6 a CC or MCC?
CMS lists P23.6 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 P23.6 be reported with a code from P24?
Not as a rule. The Excludes1 note at P23, which applies to P23.6, lists "neonatal pneumonia resulting from aspiration (P24.-)". 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).
