P70.0 vs P70.1
P70.0 and P70.1 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 P70.0
newborn (with hypoglycemia) affected by maternal (pre-existing) diabetes mellitus (P70.1)
P70.0
Syndrome of infant of mother with gestational diabetes
Billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P70-P74
Use when the record says
- Newborn (with hypoglycemia) affected by maternal gestational diabetes
Indexed under
- Diabetes, diabetic › gestational › affecting newborn (mellitus) (sugar)
- Hypoglycemia › in infant of diabetic mother › gestational diabetes (spontaneous)
- Infant › of diabetic mother › gestational diabetes (s)
- Syndrome › infant › gestational diabetes
- Newborn › affected by › maternal › gestational diabetes (infant) (liveborn) (singleton)
P70.1
Syndrome of infant of a diabetic mother
Billable
- Chapter 16
- Certain conditions originating in the perinatal period
- Section
- P70-P74
Use when the record says
- Newborn (with hypoglycemia) affected by maternal (pre-existing) diabetes mellitus
Indexed under
- Hypoglycemia › in infant of diabetic mother (spontaneous)
- Infant › of diabetic mother (s)
- Syndrome › infant › of diabetic mother
- Newborn › affected by › maternal › diabetes mellitus (infant) (liveborn) (singleton)
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