2027 ICD-10-CM Diagnosis Code P56.90Hydrops fetalis due to unspecified hemolytic disease
ICD-10-CM Codes›P00–P96›P50-P61›P56
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Risk Adjusts — HCC 109
- Not Chronic
P56.90 is a billable ICD-10-CM diagnosis code for hydrops fetalis due to unspecified hemolytic disease. 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 25 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Hemolytic jaundice and perinatal jaundice.
For Medicare Advantage risk adjustment, P56.90 maps to CMS-HCC Category 109 (Acquired Hemolytic, Aplastic, and Sideroblastic Anemias) under the V28 model, adding a risk factor of about 1.144 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
P56.90 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.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to P56.90: its own notes plus those printed at P56, block P50-P61, 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
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.
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 P56.90, its category, or a range that includes it.
Excludes1 3
These codes carry an Excludes1 note naming P56.90: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 1
These codes carry an Excludes2 note naming P56.90: its condition is not part of those codes, and both may be reported when the patient has both.
- Block R70-R79 Abnormal findings on examination of blood, without diagnosis
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
Edema
Edema means swelling caused by fluid in your body's tissues. It usually occurs in the feet, ankles and legs, but it can involve your entire body.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert P56.90 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About P56.90Overview
What is the ICD-10 code for hydrops fetalis due to unspecified hemolytic disease?
The ICD-10-CM code for hydrops fetalis due to unspecified hemolytic disease is P56.90 (sometimes written as P5690). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is P56.90 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report hydrops fetalis due to unspecified hemolytic disease on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does P56.90 group to?
When hydrops fetalis due to unspecified hemolytic disease 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 P56.90 a CC or MCC?
CMS lists P56.90 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 25 closely related codes in its exclusion list.
Can P56.90 be reported with P83.2?
Not as a rule. The Excludes1 note at P56, which applies to P56.90, lists "hydrops fetalis NOS (P83.2)". 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).
What HCC is P56.90?
P56.90 (hydrops fetalis due to unspecified hemolytic disease) maps to CMS-HCC Category 109 (Acquired Hemolytic, Aplastic, and Sideroblastic Anemias), commonly written as HCC 109, 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 P56.90 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, P56.90 adds a risk adjustment factor of about 1.144 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.529 to 1.815 depending on the payment segment). HCC 109 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 109 category page.
