2026 ICD-10-CM Diagnosis Code P36.8Other bacterial sepsis of newborn
ICD-10-CM Codes›P00–P96›P35-P39›P36
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Risk Adjusts — HCC 2
- Not Chronic
P36.8 is a billable ICD-10-CM diagnosis code for other bacterial sepsis of newborn. 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 48 closely related codes. Coders also document this condition as sepsis caused by Acinetobacter. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Bacterial infections, Perinatal infections, and Septicemia.
For Medicare Advantage risk adjustment, P36.8 maps to CMS-HCC Category 2 (Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock) under the V28 model, adding a risk factor of about 0.500 for a community, non-dual, aged beneficiary in payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
P36.8 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 2026.
Source: CMS Payment Year 2026 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.
- Sepsis caused by Acinetobacter
- Sepsis caused by Acinetobacter baumannii
- Sepsis caused by coliform bacteria
- Sepsis caused by Klebsiella pneumoniae
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Use Additional Code
- code from category B96
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.
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 P36.8 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About P36.8Overview
What is the ICD-10 code for other bacterial sepsis of newborn?
The ICD-10-CM code for other bacterial sepsis of newborn is P36.8 (sometimes written as P368). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is P36.8 (Bacterial sepsis of newborn) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report other bacterial sepsis of newborn on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does P36.8 group to?
When other bacterial sepsis of newborn 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 P36.8 a CC or MCC?
CMS lists P36.8 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 48 closely related codes in its exclusion list.
What is the ICD-9 equivalent of P36.8?
Under the General Equivalence Mappings, other bacterial sepsis of newborn converts to ICD-9-CM 771.81 (NB septicemia [sepsis]). The mapping is approximate, so confirm the match fits the documentation.
What HCC is P36.8?
P36.8 (other bacterial sepsis of newborn) maps to CMS-HCC Category 2 (Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock), commonly written as HCC 2, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 2 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.
Does P36.8 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, P36.8 adds a risk adjustment factor of about 0.500 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.447 to 0.780 depending on the payment segment). HCC 2 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 2 category page.
