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Compare/J96 vs P28.5

J96 vs P28.5

J96 (Respiratory failure, not elsewhere classified) compared with P28.5 (Respiratory failure of newborn), 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. J96 carries an Excludes1 note covering P28.5: “respiratory failure of newborn (P28.5)”

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

J96Respiratory failure, not elsewhere classifiedP28.5Respiratory failure of newborn
Billing statusNon-billable header

Report instead: J96.00, J96.01, J96.02, J96.10, J96.11

Billable
ClassificationJ00-J99 — Diseases of the Respiratory System (J00-J99)P00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96)
DefinitionRespiratory failure, not elsewhere classified is a non-billable ICD-10-CM category code (J96).Respiratory failure of newborn is a billable ICD-10-CM diagnosis code (P28.5).

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources