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P15.4 ICD-10-CM Code: Birth injury to face

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

Coding at a Glance

Tabular directives
1 inclusion term

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 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 P15.4 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Facial congestion due to birth injury

Code Overview

Birth injury to face is a billable ICD-10-CM diagnosis code (P15.4).

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 (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 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).

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, 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, P15.5 — Birth injury to external genitalia, P15.6 — Subcutaneous fat necrosis due to birth injury, P15.8 — Other specified birth injuries, P15.9 — Birth injury, unspecified, +23 more

Same Index main term, other category

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

P13.0 — Fracture of skull due to birth injury (injury NOS, fracture, skull), P13.1 — Other birth injuries to skull (injury NOS, skull NEC), P13.2 — Birth injury to femur (injury NOS, fracture, femur), P13.3 — Birth injury to other long bones (injury NOS, fracture, humerus), P13.4 — Fracture of clavicle due to birth injury (injury NOS, fracture, clavicle), P13.8 — Birth injuries to other parts of skeleton (injury NOS, fracture, bone, specified NEC), P13.9 — Birth injury to skeleton, unspecified (injury NOS, fracture, bone), 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), P52.4 — Intracerebral (nontraumatic) hemorrhage of newborn (brain, newborn NEC), P52.5 — Subarachnoid (nontraumatic) hemorrhage of newborn (subarachnoid, newborn), P52.8 — Other intracranial (nontraumatic) hemorrhages of newborn (subdural, newborn), P54.5 — Neonatal cutaneous hemorrhage (superficial, newborn), P96.89 — Other specified conditions originating in the perinatal period (shock, newborn), R09.81 — Nasal congestion (nose), R09.89 — Other specified symptoms and signs involving the circulatory and respiratory systems (lung), R68.89 — Other general symptoms and signs (general), S06.34 — Traumatic hemorrhage of right cerebrum (cerebrum, right), S06.35 — Traumatic hemorrhage of left cerebrum (cerebrum, left), +70 more

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.

Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of P15.4 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, face[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Congestion, congestive, facial, due to birth injury[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Hematoma (traumatic) (skin surface intact), face, birth injury[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (9)

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. "P15.4 — Birth injury to face." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/p15.4-birth-injury-to-face

Change history

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

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 P15.4 in its code family, with their registry titles.

View all codes in the P15 family