FY2027
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Excludes1 pair

P22.8 vs P28.5

P22.8 and P28.5 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 P22.8
respiratory failure of newborn NOS (P28.5)
P22.8

Other respiratory distress of newborn

Billable
Chapter 16
Certain conditions originating in the perinatal period
Section
P19-P29
Indexed under
  • Distress › respiratory › newborn › specified NEC
P28.5

Respiratory failure of newborn

Billable
Chapter 16
Certain conditions originating in the perinatal period
Section
P19-P29
Indexed under
  • Failure, failed › respiration, respiratory › newborn
  • Inadequate, inadequacy › pulmonary › ventilation, newborn
  • Insufficiency, insufficient › respiratory › newborn
  • Respiration › insufficient, or poor › newborn
  • Inadequate, inadequacy › pulmonary › function › newborn

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