E16.1 vs P70.4
E16.1 (Other hypoglycemia) compared with P70.4 (Other neonatal hypoglycemia), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. E16.1 carries an Excludes1 note covering P70.4: “neonatal hypoglycemia (P70.4)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| E16.1Other hypoglycemia | P70.4Other neonatal hypoglycemia | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | E00-E89 — Endocrine, Nutritional and Metabolic Diseases (E00-E89) | P00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96) |
| Definition | Other hypoglycemia is a billable ICD-10-CM diagnosis code (E16.1). | Other neonatal hypoglycemia is a billable ICD-10-CM diagnosis code (P70.4). |
| Includes | Functional hyperinsulinism Functional nonhyperinsulinemic hypoglycemia Hyperinsulinism NOS Hyperplasia of pancreatic islet beta cells NOS | transitory endocrine and metabolic disturbances caused by the infant's response to maternal endocrine and metabolic factors, or its adjustment to extrauterine environment Transitory neonatal hypoglycemia |
| Use additional code | code for hypoglycemia level, if applicable (E16.A-) | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources