P23.0 vs P35.0
P23.0 (Congenital pneumonia due to viral agent) compared with P35.0 (Congenital rubella syndrome), 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. P23.0 carries an Excludes1 note covering P35.0: “congenital rubella pneumonitis (P35.0)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Yes, when both are documented. P35.0 carries an Excludes2 note covering P23.0: “congenital pneumonia (P23.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| P23.0Congenital pneumonia due to viral agent | P35.0Congenital rubella syndrome | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | P00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96) | P00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96) |
| Definition | Congenital pneumonia due to viral agent is a billable ICD-10-CM diagnosis code (P23.0). | Congenital rubella syndrome is a billable ICD-10-CM diagnosis code (P35.0). |
| Includes | infective pneumonia acquired in utero or during birth | infections acquired in utero or during birth Congenital rubella pneumonitis |
| Use additional code | code (B97) to identify organism | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources