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P05.10 ICD-10-CM Code: Newborn small for gestational age, unspecified weight

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 794 — NEONATE WITH OTHER SIGNIFICANT PROBLEMS (MDC 15)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coder workflow for P05.10

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

Before you code P05.10

  1. Unspecified does not mean incorrect. When the record gives no greater specificity, P05.10 may be the appropriate code. Check the record for detail that supports a more specific sibling. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).

    ReviewP05.11, P05.12, P05.13, P05.14, P05.15, P05.16, P05.17, P05.18

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

Choose the right path

  1. Does the record document the detail a more specific sibling code needs?
    Yes → Review the specific siblings in this subcategory.
    No → Continue — P05.10 is appropriate when the documentation goes no further.

    ReviewP05.11, P05.12, P05.13, P05.14, P05.15, P05.16, P05.17, P05.18

Consider P05.10. 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).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Coding decision scenarios

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

Documentation: The provider documents the condition in the terms of this code’s title and records no further detail.

Coding question: Is a more specific sibling code supportable?

Path: Review the specific siblings in this subcategory and what each requires the record to state.

Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).

ReviewP05.11, P05.12, P05.13, P05.14, P05.15, P05.16, P05.17, P05.18

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.

Coding context

The comparisons, hierarchy, index entries, guidelines, relationships, risk-adjustment and coverage context a coder commonly needs. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Newborn small for gestational age, unspecified weight is a billable ICD-10-CM diagnosis code (P05.10).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (1)

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.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 16: Certain Conditions Originating in the Perinatal Period (P00-P96)

d. Prematurity and Fetal Growth Retardation Providers utilize different criteria in determining prematurity. A code for prematurity should not be assigned unless it is documented. Assignment of codes in categories P05, Disorders of newborn related to slow fetal growth and fetal malnutrition, and P07, Disorders of newborn related to short gestation and low birth weight, not elsewhere classified, should be based on the recorded birth weight and estimated gestational age.

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 P05.10 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 3 Excludes1 notes: P05.2 — Newborn affected by fetal (intrauterine) malnutrition not light or small for gestational age (via P05.1.-), P07.0 — Extremely low birth weight newborn (via P05.-), P07.1 — Other low birth weight newborn (via P05.-).

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

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

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):PNL002 — Short gestation; low birth weight; and fetal growth retardation (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 (Short gestation; low birth weight; and fetal growth retardation).

P05.00 — Newborn light for gestational age, unspecified weight, P05.01 — Newborn light for gestational age, less than 500 grams, P05.02 — Newborn light for gestational age, 500-749 grams, P05.03 — Newborn light for gestational age, 750-999 grams, P05.04 — Newborn light for gestational age, 1000-1249 grams, P05.05 — Newborn light for gestational age, 1250-1499 grams, P05.06 — Newborn light for gestational age, 1500-1749 grams, P05.07 — Newborn light for gestational age, 1750-1999 grams, P05.08 — Newborn light for gestational age, 2000-2499 grams, P05.09 — Newborn light for gestational age, 2500 grams and over, P05.11 — Newborn small for gestational age, less than 500 grams, P05.12 — Newborn small for gestational age, 500-749 grams, P05.13 — Newborn small for gestational age, 750-999 grams, P05.14 — Newborn small for gestational age, 1000-1249 grams, P05.15 — Newborn small for gestational age, 1250-1499 grams, P05.16 — Newborn small for gestational age, 1500-1749 grams, P05.17 — Newborn small for gestational age, 1750-1999 grams, P05.18 — Newborn small for gestational age, 2000-2499 grams, P05.19 — Newborn small for gestational age, other, P05.2 — Newborn affected by fetal (intrauterine) malnutrition not light or small for gestational age, +28 more

Same Index main term, other category

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

R63.4 — Abnormal weight loss (loss), R63.5 — Abnormal weight gain (gain)

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Lipid Panel

Contextual Map

Every relationship of P05.10 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 P05.10 with these 3 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

Index entries

  • Small-for-dates (infant)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes (24)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Deep reference

Published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 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 — v44 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.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCD code lists 2026-01 · LCD export September 20, 2026 · All releases and sources

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

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "P05.10 — Newborn small for gestational age, unspecified weight." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/p05.10-newborn-small-for-gestational-age-unspecified-weight

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Newborn small for gestational age, unspecified weight

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to P05.10 in its code family, with their registry titles.

View all codes in the P05 family