P03.811 ICD-10-CM Code: Newborn affected by abnormality in fetal (intrauterine) heart rate or rhythm during labor

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for P03.811 in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on P03.811 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for P03.811

MedCoder structured workflow — derived from this code’s own official record

Before you code P03.811

1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with P03.811. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

   See the official tabular notes

Choose the right path

1. Does the documentation support a condition named in P03.811’s Excludes1 note?
   Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
   No → Continue.

   ReviewP29.1

2. Is the underlying (etiologic) condition the Code First note names documented?
   Yes → Sequence the underlying condition first, then P03.811.
   No → Continue; do not add an underlying condition the record does not document.

Consider P03.811. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

The underlying (etiologic) condition

Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).

Official instructions as workflow

• Excludes1 — check before selecting P03.811(1 note)

  Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with P03.811: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

  CompareP29.1

  See the official tabular notes · Guidelines I.A.12.a

• Excludes2 — not part of P03.811(1 note)

  Coding workflow: The conditions named in this note are not included in P03.811. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareZ05

  See the official tabular notes · Guidelines I.A.12.b

• Code First — sequencing check(1 note)

  Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before P03.811. Do not add an underlying condition the record does not document.

  See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Indexed Clinical Terms (3)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Arrhythmia (auricle)(cardiac)(juvenile)(nodal)(reflex)(supraventricular)(transitory)(ventricle), newborn, occurring before birth, during labor
• Dysrhythmia, cardiac, newborn, occurring before birth, during labor
• Newborn (infant) (liveborn) (singleton), affected by, heart rate abnormalities, intrauterine, during labor

Don’t confuse P03.811 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of P03.811 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• P29.1— Excludes1 conflict (Conflict)

  Not coded here — these two are mutually exclusive.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of neonatal cardiac dysrhythmia moves the case to P29.1; the two are not reported together unless documented as unrelated.

  Full comparison: P03.811 vs P29.1 →

• P03.819— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Newborn affected by abnormality in fetal (intrauterine) heart rate or rhythm, unspecified as to time of onset” takes P03.819; specificity in the record moves it back here.

  Full comparison: P03.811 vs P03.819 →

• Z05— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of encounter for observation of newborn for suspected diseases and conditions ruled out adds Z05; it is not part of this code and both may be reported when both are documented.

  Full comparison: P03.811 vs Z05 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

1. Sequencing: 1 Code First instruction — the underlying condition is sequenced before this code when present. See the Code First notes
2. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
3. 1 Excludes2 entry — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

• No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name P03.811 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: P00.7 — Newborn affected by other medical procedures on mother, not elsewhere classified (via P03.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 1 MS-DRG: DRG 794 (MDC 15).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):PNL010 — Newborn affected by maternal conditions or complications of labor/delivery (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Newborn affected by maternal conditions or complications of labor/delivery).

P02.8 — Newborn affected by other abnormalities of membranes, P02.9 — Newborn affected by abnormality of membranes, unspecified, P03.0 — Newborn affected by breech delivery and extraction, P03.1 — Newborn affected by other malpresentation, malposition and disproportion during labor and delivery, P03.2 — Newborn affected by forceps delivery, P03.3 — Newborn affected by delivery by vacuum extractor [ventouse], P03.4 — Newborn affected by Cesarean delivery, P03.5 — Newborn affected by precipitate delivery, P03.6 — Newborn affected by abnormal uterine contractions, P03.810 — Newborn affected by abnormality in fetal (intrauterine) heart rate or rhythm before the onset of labor, P03.819 — Newborn affected by abnormality in fetal (intrauterine) heart rate or rhythm, unspecified as to time of onset, P03.82 — Meconium passage during delivery, P03.89 — Newborn affected by other specified complications of labor and delivery, P03.9 — Newborn affected by complication of labor and delivery, unspecified, P04.0 — Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery, P04.1 — Newborn affected by other maternal medication, P04.11 — Newborn affected by maternal antineoplastic chemotherapy, P04.12 — Newborn affected by maternal cytotoxic drugs, P04.13 — Newborn affected by maternal use of anticonvulsants, P04.14 — Newborn affected by maternal use of opiates, +53 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Newborn”; these codes share that main term but sit in a different category of the Tabular List.

P02.29 — Newborn affected by other morphological and functional abnormalities of placenta (affected by, placental, infarction), P02.3 — Newborn affected by placental transfusion syndromes (affected by, placental, transfusion syndromes), P02.4 — Newborn affected by prolapsed cord (affected by, prolapsed cord), P02.5 — Newborn affected by other compression of umbilical cord (affected by, umbilical cordaround neck), P02.60 — Newborn affected by unspecified conditions of umbilical cord (affected by, umbilical cord condition), P02.69 — Newborn affected by other conditions of umbilical cord (affected by, vasa previa), P02.70 — Newborn affected by fetal inflammatory response syndrome (affected by, FIRS), P02.78 — Newborn affected by other conditions from chorioamnionitis (affected by, amnionitis), P02.8 — Newborn affected by other abnormalities of membranes (affected by, membrane abnormalities, specified NEC), P02.9 — Newborn affected by abnormality of membranes, unspecified (affected by, membrane abnormalities), P04.0 — Newborn affected by maternal anesthesia and analgesia in pregnancy, labor and delivery (affected by, maternal, analgesia), P04.11 — Newborn affected by maternal antineoplastic chemotherapy (affected by, chemotherapy agents), P04.12 — Newborn affected by maternal cytotoxic drugs (affected by, maternal, cytotoxic drugs), P04.13 — Newborn affected by maternal use of anticonvulsants (affected by, maternal, anticonvulsants), P04.14 — Newborn affected by maternal use of opiates (affected by, maternal, opiates), P04.15 — Newborn affected by maternal use of antidepressants (affected by, maternal, antidepressants), P04.16 — Newborn affected by maternal use of amphetamines (affected by, maternal, amphetamines), P04.17 — Newborn affected by maternal use of sedative-hypnotics (affected by, maternal, sedative-hypnotics), P04.18 — Newborn affected by other maternal medication (affected by, maternal, medication, specified type NEC), P04.19 — Newborn affected by maternal use of unspecified medication (affected by, medication), +145 more

Contextual Map

Every relationship of P03.811 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run P03.811 with this related code in Claim Check

Hierarchy

• P00-P96 — Chapter 16: Certain Conditions Originating in the Perinatal Period (P00-P96) (P00-P96)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P00-P04 — Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Referenced by Excludes1 notes

• P00.7 — Newborn affected by other medical procedures on mother, not elsewhere classified[Excludes1](via P03.-): “newborn affected by other complications of labor and delivery (P03.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• PNL010 — Newborn affected by maternal conditions or complications of labor/delivery[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

MS-DRG Grouper

• DRG 794 — NEONATE WITH OTHER SIGNIFICANT PROBLEMS[MS-DRG]: “NEONATE WITH OTHER SIGNIFICANT PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period[MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

• Arrhythmia (auricle)(cardiac)(juvenile)(nodal)(reflex)(supraventricular)(transitory)(ventricle), newborn, occurring before birth, during labor[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Dysrhythmia, cardiac, newborn, occurring before birth, during labor[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Newborn (infant) (liveborn) (singleton), affected by, heart rate abnormalities, intrauterine, during labor[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (15)

• P03 — Newborn affected by other complications of labor and delivery[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P03.0 — Newborn affected by breech delivery and extraction[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P03.1 — Newborn affected by other malpresentation, malposition and disproportion during labor and delivery[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P03.2 — Newborn affected by forceps delivery[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P03.3 — Newborn affected by delivery by vacuum extractor [ventouse][Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P03.4 — Newborn affected by Cesarean delivery[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P03.5 — Newborn affected by precipitate delivery[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P03.6 — Newborn affected by abnormal uterine contractions[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 7 more

Change history (2)

• FY2017 — Description revised[Change history]— CMS release files (code change ledger) · icd10cm-fy2017
• and 1 more

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to P03.811 in its code family, with their registry titles.

• P03.4 — Newborn affected by Cesarean delivery
• P03.5 — Newborn affected by precipitate delivery
• P03.6 — Newborn affected by abnormal uterine contractions
• P03.8 — Newborn affected by other specified complications of labor and delivery
• P03.81 — Newborn affected by abnormality in fetal (intrauterine) heart rate or rhythm
• P03.810 — Newborn affected by abnormality in fetal (intrauterine) heart rate or rhythm before the onset of labor
• P03.819 — Newborn affected by abnormality in fetal (intrauterine) heart rate or rhythm, unspecified as to time of onset
• P03.82 — Meconium passage during delivery
• P03.89 — Newborn affected by other specified complications of labor and delivery
• P03.9 — Newborn affected by complication of labor and delivery, unspecified

View all codes in the P03 family