FY2027
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Excludes1 pair

P08.0 vs P08.1

P08.0 and P08.1 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.

The official note, declared on P08.1
newborn with a birth weight of 4500 or more (P08.0)
P08.0

Exceptionally large newborn baby

Billable
Chapter 16
Certain conditions originating in the perinatal period
Section
P05-P08
Use when the record says
  • Usually implies a birth weight of 4500 g. or more
Indexed under
  • Heavy-for-dates NEC › exceptionally (4500g or more)
  • Large-for-dates NEC › exceptionally (4500g or more)
  • Birth › weight › 4500 grams or more
  • Excess, excessive, excessively › large › infant
P08.1

Other heavy for gestational age newborn

Billable
Chapter 16
Certain conditions originating in the perinatal period
Section
P05-P08
Use when the record says
  • Other newborn heavy- or large-for-dates regardless of period of gestation
  • Usually implies a birth weight of 4000 g. to 4499 g.
Indexed under
  • Heavy-for-dates NEC (infant) (4000g to 4499g)
  • Large-for-dates NEC (infant) (4000g to 4499g)
  • Large › baby (regardless of gestational age) (4000g to 4499g)
  • Birth › weight › 4000 grams to 4499 grams

Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027