2027 ICD-10-CM Diagnosis Code P28.81Respiratory arrest of newborn
ICD-10-CM Codes›P00–P96›P19-P29›P28
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Risk Adjusts — HCC 212
- Not Chronic
P28.81 is a billable ICD-10-CM diagnosis code for respiratory arrest of newborn. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 794. 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 26 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Respiratory perinatal condition.
For Medicare Advantage risk adjustment, P28.81 maps to CMS-HCC Category 212 (Respiratory Arrest) 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
P28.81 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.
- Anoxic encephalopathy
- Anoxic encephalopathy due to respiratory arrest
- Cardiorespiratory arrest
- Cardiorespiratory failure
- Cardiorespiratory failure during AND/OR resulting from a procedure
- Central nervous system depression
- Neonatal respiratory arrest
- Neonatal respiratory failure
- Respiratory arrest
- Respiratory arrest preceding cardiac arrest
- Respiratory insufficiency syndrome of newborn
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to P28.81: its own notes plus those printed at P28 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.
- 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
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.
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
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 P28.81, its category, or a range that includes it.
Excludes1 6
These codes carry an Excludes1 note naming P28.81: they are not reported together with it, unless the two conditions are unrelated.
- J96 Respiratory failure, not elsewhere classifiedrespiratory arrest of newborn (P28.81)
- P22.8 Other respiratory distress of newbornrespiratory arrest of newborn (P28.81)
- P22.9 Respiratory distress of newborn, unspecifiedrespiratory arrest of newborn (P28.81)
- R06 Abnormalities of breathingrespiratory arrest of newborn (P28.81)
- R09 Other symptoms and signs involving the circulatory and respiratory systemrespiratory arrest of newborn (P28.81)
- R09.2 Respiratory arrestrespiratory arrest of newborn (P28.81)
Excludes2 2
These codes carry an Excludes2 note naming P28.81: 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.
newborn P28.81
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 P28.81 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About P28.81Overview
What is the ICD-10 code for respiratory arrest of newborn?
The ICD-10-CM code for respiratory arrest of newborn is P28.81 (sometimes written as P2881). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is P28.81 (Other specified respiratory conditions of newborn) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report respiratory arrest of newborn on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does P28.81 group to?
When respiratory arrest of newborn is the principal diagnosis on an inpatient stay, it groups to MS-DRG 794 (neonate with Other Significant Problems), which carries a relative weight of 1.4934. Higher weights mean higher Medicare reimbursement.
Is P28.81 a CC or MCC?
CMS lists P28.81 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 26 closely related codes in its exclusion list.
What is the ICD-9 equivalent of P28.81?
Under the General Equivalence Mappings, respiratory arrest of newborn converts to ICD-9-CM 770.87 (NB respiratory arrest). The mapping is a direct match.
What HCC is P28.81?
P28.81 (respiratory arrest of newborn) maps to CMS-HCC Category 212 (Respiratory Arrest), commonly written as HCC 212, 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 P28.81 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, P28.81 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) supersedes it when both are reported. See the full factor table on the HCC 212 category page.
