Alphabetic Index FY2027

P91.811

Neonatal encephalopathy in diseases classified elsewhere

FY2027Chapter 16: Certain conditions originating in the perinatal period/P90–P96 Other disorders originating in the perinatal period

BillableComplete code, valid to report
Care settingsHospice: not accepted as primary

P91.811 (also written P91811) is a billable ICD-10-CM diagnosis code for neonatal encephalopathy in diseases classified elsewhere. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 18 codes in category P91 (Other disturbances of cerebral status of newborn). The Alphabetic Index lists it under 1 entry. Its coding notes include a Code first instruction and 5 Excludes2 entries.

Guidelines tip

From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.

Chapter 16 codes are never used on the maternal record, and chapter 15 codes are never used on the newborn record. Chapter 16 codes can be used for life if the condition persists.

Guidelines I.C.16.a.1Perinatal codes and the maternal recordRead the official text

Code first

If the underlying condition listed here is present and known, sequence it first.

This code
  • underlying condition, if known, such as:
    • congenital cirrhosis (of liver) (P78.81)
    • intracranial nontraumatic hemorrhage of newborn (P52.-)
    • kernicterus (P57.-)

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Also from chapter/block level (5 notes)
Inherited from Chapter 16 Certain conditions originating in the perinatal period
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • tetanus neonatorum (A33)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Hospice: not accepted as primary

Not accepted as the principal diagnosis on a hospice claim (bill types 081x and 082x). The Integrated OCE returns an edit for this code.
Reason: Manifestation code. Report the underlying condition first (see the Code first note).

Source: CMS Integrated Outpatient Code Editor (IOCE) v27.3, effective October 1, 2026, edit 86

Includes

Further defines or gives examples of the content of the category.

Also from chapter/block level (1 note)
Inherited from Chapter 16 Certain conditions originating in the perinatal period
  • 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

Notes

Also from chapter/block level (1 note)
Inherited from Chapter 16 Certain conditions originating in the perinatal period
  • Codes from this chapter are for use on newborn records only, never on maternal records

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 1 entry