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P13.9 ICD-10-CM Code: Birth injury to skeleton, unspecified

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

Coding at a Glance

Tabular directives
1 Excludes2

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.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for P13.9 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on P13.9 itself; “inherited from” names the category or block whose note applies here.

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from P13

Coder workflow for P13.9

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

Before you code P13.9

  1. Unspecified does not mean incorrect. When the record gives no greater specificity, P13.9 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).

    ReviewP13.0, P13.1, P13.2, P13.3, P13.4, P13.8

    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 — P13.9 is appropriate when the documentation goes no further.

    ReviewP13.0, P13.1, P13.2, P13.3, P13.4, P13.8

Consider P13.9. 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.

Official instructions as workflow

  • Excludes2 — not part of P13.9(1 note)

    Coding workflow: The conditions named in this note are not included in P13.9. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareP11.5

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

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).

ReviewP13.0, P13.1, P13.2, P13.3, P13.4, P13.8

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.

Don’t confuse P13.9 with…

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

The codes most likely to be picked instead of P13.9 — 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.

  • P11.5— 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 birth injury to spine adds P11.5; it is not part of this code and both may be reported when both are documented.

    Full comparison: P13.9 vs P11.5 →

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.

Code Overview

Birth injury to skeleton, unspecified is a billable ICD-10-CM diagnosis code (P13.9).

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 (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.

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 (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):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).

P12.4 — Injury of scalp of newborn due to monitoring equipment, P12.81 — Caput succedaneum, 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, P14.0 — Erb's paralysis due to birth injury, P14.1 — Klumpke's paralysis due to birth injury, P14.2 — Phrenic nerve paralysis due to birth injury, P14.3 — Other brachial plexus birth injuries, P14.8 — Birth injuries to other parts of peripheral nervous system, P14.9 — Birth injury to peripheral nervous system, unspecified, P15.0 — Birth injury to liver, P15.1 — Birth injury to spleen, P15.2 — Sternomastoid injury due to birth injury, P15.3 — Birth injury to eye, +23 more

Same Index main term, other category

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

P10.4 — Tentorial tear due to birth injury (injury NOS, tentorial tear), P10.8 — Other intracranial lacerations and hemorrhages due to birth injury (injury NOS, intracranial, laceration or hemorrhage, specified NEC), P10.9 — Unspecified intracranial laceration and hemorrhage due to birth injury (injury NOS, intracranial, laceration or hemorrhage), P11.1 — Other specified brain damage due to birth injury (injury NOS, cerebellum), P11.2 — Unspecified brain damage due to birth injury (injury NOS, brain), P11.3 — Birth injury to facial nerve (injury NOS, nerve, facial), P11.4 — Birth injury to other cranial nerves (injury NOS, nerve, cranial NEC), P11.5 — Birth injury to spine and spinal cord (injury NOS, spine), P11.9 — Birth injury to central nervous system, unspecified (injury NOS, central nervous system NOS), P12.9 — Birth injury to scalp, unspecified (injury NOS, scalp), P14.2 — Phrenic nerve paralysis due to birth injury (injury NOS, nerve, phrenic), P14.3 — Other brachial plexus birth injuries (injury NOS, brachial plexus NEC), P14.9 — Birth injury to peripheral nervous system, unspecified (injury NOS, nerve, peripheral), P15.0 — Birth injury to liver (injury NOS, liver), P15.1 — Birth injury to spleen (injury NOS, spleen), P15.2 — Sternomastoid injury due to birth injury (injury NOS, sternomastoid), P15.3 — Birth injury to eye (injury NOS, eye), P15.4 — Birth injury to face (injury NOS, face), P15.5 — Birth injury to external genitalia (injury NOS, penis), P15.6 — Subcutaneous fat necrosis due to birth injury (injury NOS, subcutaneous fat necrosis), +9 more

Contextual Map

Every relationship of P13.9 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

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

Index entries

  • Birth, injury NOS, fracture, bone[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Fracture, traumatic (abduction) (adduction) (separation), bone NEC, birth injury[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Injury, skeleton, birth injury[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes

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
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 · NCCI PTP Q4 2026 · MUE Q4 2026 · 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. "P13.9 — Birth injury to skeleton, unspecified." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/p13.9-birth-injury-to-skeleton-unspecified

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Birth injury to skeleton, unspecified

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 P13.9 in its code family, with their registry titles.

View all codes in the P13 family