P12.81 ICD-10-CM Code: Caput succedaneum
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 v43, Appendix B.
- MS-DRG 795 — NORMAL NEWBORN (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.
Code Overview
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 (2)
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.
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
MS-DRG Grouper Relationships (FY2026)
Potential MS-DRG participation — not a DRG assignment.
FY2026 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 795 (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):PNL008 — Birth trauma (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 (Birth trauma).
P11.2 — Unspecified brain damage due to birth injury, P11.3 — Birth injury to facial nerve, P11.4 — Birth injury to other cranial nerves, P11.5 — Birth injury to spine and spinal cord, P11.9 — Birth injury to central nervous system, unspecified, P12.0 — Cephalhematoma due to birth injury, P12.1 — Chignon (from vacuum extraction) due to birth injury, P12.2 — Epicranial subaponeurotic hemorrhage due to birth injury, P12.3 — Bruising of scalp due to birth injury, P12.4 — Injury of scalp of newborn due to monitoring equipment, P12.89 — Other birth injuries to scalp, P12.9 — Birth injury to scalp, unspecified, P13.0 — Fracture of skull due to birth injury, P13.1 — Other birth injuries to skull, P13.2 — Birth injury to femur, P13.3 — Birth injury to other long bones, P13.4 — Fracture of clavicle due to birth injury, P13.8 — Birth injuries to other parts of skeleton, P13.9 — Birth injury to skeleton, unspecified, P14.0 — Erb's paralysis due to birth injury, +23 more
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Caput”; these codes share that main term but sit in a different category of the Tabular List.
I86.8 — Varicose veins of other specified sites (medusae), Q75.8 — Other specified congenital malformations of skull and face bones (crepitus)
Contextual Map
Every relationship of P12.81 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.
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
- P10-P15 — Birth trauma[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Clinical classification (CCSR)
- PNL008 — Birth trauma[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- DRG 795 — NORMAL NEWBORN[MS-DRG]: “NORMAL NEWBORN (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
- Caput, succedaneum[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Injury, scalp, newborn (birth injury), specified NEC, caput succedaneum[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Nearest codes (9)
- P12 — Birth injury to scalp[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- P12.0 — Cephalhematoma due to birth injury[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- P12.1 — Chignon (from vacuum extraction) due to birth injury[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- P12.2 — Epicranial subaponeurotic hemorrhage due to birth injury[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- P12.3 — Bruising of scalp due to birth injury[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- P12.4 — Injury of scalp of newborn due to monitoring equipment[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- P12.8 — Other birth injuries to scalp[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- P12.89 — Other birth injuries to scalp[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 1 more
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
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
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. "P12.81 — Caput succedaneum." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/p12.81-caput-succedaneum
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionCaput succedaneum
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), 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 P12.81 in its code family, with their registry titles.
- P12 — Birth injury to scalp
- P12.0 — Cephalhematoma due to birth injury
- P12.1 — Chignon (from vacuum extraction) due to birth injury
- P12.2 — Epicranial subaponeurotic hemorrhage due to birth injury
- P12.3 — Bruising of scalp due to birth injury
- P12.4 — Injury of scalp of newborn due to monitoring equipment
- P12.8 — Other birth injuries to scalp
- P12.89 — Other birth injuries to scalp
- P12.9 — Birth injury to scalp, unspecified