2027 ICD-10-CM Diagnosis Code Z38.1Single liveborn infant, born outside hospital
Z38.1 is a billable ICD-10-CM diagnosis code for single liveborn infant, born outside hospital. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 795. The code is restricted by the Medicare Code Editor to newborn patients (age 0) and exempt from POA reporting. Coders also document this condition as born at home. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Liveborn.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for Z38.1.
Present on Admission (POA)Billing
Z38.1 is exempt from POA reporting on inpatient claims to general acute care hospitals. Review the other POA exempt codes in Persons encountering health services in circumstances related to reproduction (Z30-Z39).
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Born at home
- Born before arrival
- Born before arrival of midwife
- Born before arrival to hospital
- Born in ambulance
- Home birth
- Livebirth born before admission to hospital
- Out-of-hospital birth
- Place of birth - finding
- Singleton liveborn born outside hospital
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to Z38.1: its own notes plus those printed at Chapter 21. A note printed at a category, block or chapter applies to every code under it.
Notes
General instructions on how these codes are used.
- Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
- (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
- (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Infant (s) See Also: Infancy;
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Childbirth
Childbirth is the process of giving birth to a baby. It includes labor and delivery of the fetus and the placenta. The placenta is the organ that supplies food and oxygen through the umbilical cord to your fetus during pregnancy.
The full article covers:
- What is childbirth?
- How do I know if I'm going into labor?
- What are the stages of labor?
- What are the options for pain relief during childbirth?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert Z38.1 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About Z38.1Overview
What is the ICD-10 code for single liveborn infant, born outside hospital?
The ICD-10-CM code for single liveborn infant, born outside hospital is Z38.1 (sometimes written as Z381). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is Z38.1 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report single liveborn infant, born outside hospital on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does Z38.1 group to?
When single liveborn infant, born outside hospital is the principal diagnosis on an inpatient stay, it groups to MS-DRG 795 (normal Newborn), which carries a relative weight of 0.2022. Higher weights mean higher Medicare reimbursement.
Who can Z38.1 be reported for?
The Medicare Code Editor checks single liveborn infant, born outside hospital against patient demographics: this code is intended for newborn patients (age 0). Claims outside these limits are flagged as inconsistent.
Is Z38.1 exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for single liveborn infant, born outside hospital on inpatient claims. The code appears in the Persons encountering health services in circumstances related to reproduction (Z30-Z39) range of the CMS exempt list.
