2026 ICD-10-CM Diagnosis Code P78.0Perinatal intestinal perforation
ICD-10-CM Codes›P00–P96›P76-P78›P78
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Risk Adjusts — HCC 78
- Not Chronic
P78.0 is a billable ICD-10-CM diagnosis code for perinatal intestinal perforation. 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 36 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Neonatal digestive and feeding disorders.
For Medicare Advantage risk adjustment, P78.0 maps to CMS-HCC Category 78 (Intestinal Obstruction/Perforation) under the V28 model, adding a risk factor of about 0.326 for a community, non-dual, aged beneficiary in payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
P78.0 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.
- Delayed perforation of colon
- Fecal peritonitis
- Fetal gastrointestinal abnormality
- Gastrointestinal perforation
- Inflammatory perforation of small intestine
- Injury of sigmoid colon
- Injury of transverse colon
- Meconium ileus
- Meconium peritonitis
- Neonatal intestinal perforation co-occurrent and due to intestinal atresia
- Neonatal intestinal perforation due to in utero intestinal volvulus
- Neonatal intestinal perforation with in utero intraluminal obstruction
- Neonatal isolated ileal perforation
- Neonatal obstruction of intestine
- Neonatal perforation of intestine caused by drug
- Neonatal perforation of intestine due to congenital stenosis of intestine
- Neonatal peritonitis
- Nontraumatic perforation of large intestine
- Nontraumatic perforation of small intestine
- Perforated ulcer of intestine
- Perforation of colon
- Perforation of ileum
- Perforation of intestine
- Perforation of intestine co-occurrent and due to meconium ileus
- Perforation of jejunum
- Perforation of sigmoid colon
- Perforation of small intestine
- Perforation of terminal ileum
- Perforation of transverse colon
- Perinatal intestinal obstruction
- Perinatal intestinal perforation
- Rupture of colon
- Rupture of ileum
- Rupture of intestine
- Rupture of jejunum
- Rupture of rectum
- Rupture of small intestine
- Spontaneous perforation of large intestine
- Traumatic perforation of large intestine
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Meconium peritonitis
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
peritonitis P78.0
Newborn (infant) (liveborn) (singleton) Z38.2
intestinal perforation P78.0
meconium peritonitis P78.0
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Meconium Ileus
intestinal obstruction caused by congealed meconium in the distal ileum and cecum. it presents shortly after birth as a failure to pass meconium and frequently occurs in infants with cystic fibrosis.Cystic Fibrosis with Meconium Ileus
a congenital metabolic detected in the neonatal period that is characterized by the presence of a meconium ileus. the disease affects the exocrine glands andis inherited as an autosomal trait. the secretions of exocrine glands are abnormal, resulting in excessively viscid mucus production which causes obstruction of passageways (including pancreatic and bile ducts, intestines, and bronchi). the sweat sodium and chloride content are increased. symptoms usually appear in childhood and include meconium ileus, poor growth despite good appetite, malabsorption and foul bulky stools, chronic bronchitis with cough, recurrent pneumonia, bronchiectasis, emphysema, clubbing of the fingers, and salt depletion in hot weather.Meconium Ileus
small intestinal obstruction that results from the impaction of thick meconium in the distal small intestine.Meconium Peritonitis
inflammation of the peritoneum caused by an intrauterine intestinal perforation leading to presence of meconium within the fetal peritoneal cavity. this is frequently seen as intra-abdominal calcifications on imaging.
Patient EducationClinical
Colonic Diseases
Your colon, also known as the large intestine, is part of your digestive system. It's a long, hollow tube at the end of your digestive tract where your body makes and stores stool. Many disorders affect the colon's ability to work properly. Some of these include:
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert P78.0 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About P78.0Overview
What is the ICD-10 code for perinatal intestinal perforation?
The ICD-10-CM code for perinatal intestinal perforation is P78.0 (sometimes written as P780). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is P78.0 (Other perinatal digestive system disorders) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report perinatal intestinal perforation on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does P78.0 group to?
When perinatal intestinal perforation 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 P78.0 a CC or MCC?
CMS lists P78.0 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 36 closely related codes in its exclusion list.
What is the ICD-9 equivalent of P78.0?
Under the General Equivalence Mappings, perinatal intestinal perforation converts to ICD-9-CM 777.6 (perinatal intest perfor). The mapping is a direct match.
What HCC is P78.0?
P78.0 (perinatal intestinal perforation) maps to CMS-HCC Category 78 (Intestinal Obstruction/Perforation), commonly written as HCC 78, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It does not map to any RxHCC in the Part D prescription drug model.
Does P78.0 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, P78.0 adds a risk adjustment factor of about 0.326 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.326 to 0.688 depending on the payment segment). A more severe related category (HCC 77) supersedes it when both are reported. See the full factor table on the HCC 78 category page.
