P19 vs P74.0
P19 and P74.0 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on P74.0
(fetal) metabolic acidosis of newborn (P19)
P19
Metabolic acidemia in newborn
Not billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P19-P29
Use when the record says
- metabolic acidemia in newborn
P74.0
Late metabolic acidosis of newborn
Billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P70-P74
Indexed under
- Newborn › late metabolic acidosis (infant) (liveborn) (singleton)
- Acidosis › metabolic NEC › late, of newborn (lactic)
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