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P55.0 ICD-10-CM Code: Rh isoimmunization of newborn

Compare with another code for P55.0Check this code on a claim

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

Coding at a Glance

Tabular directives
5 Excludes1
Risk adjustment
CMS-HCC V28: 1 category

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Excludes1from P50-P61Not reported with this code unless documented as unrelated
  • congenital stenosis and stricture of bile ducts (Q44.3)
  • Crigler-Najjar syndrome (E80.5)
  • Dubin-Johnson syndrome (E80.6)
  • Gilbert syndrome (E80.4)

+1 more in Instructions

Where it sits Source: CMS/NCHS

Under:Chapter 16: Certain Conditions Originating in the Perinatal PeriodP50-P61 Hemorrhagic and hematological disorders of newbornP55 Hemolytic disease of newborn

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

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.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 109 — Acquired Hemolytic, Aplastic, and Sideroblastic Anemias

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for P55.0 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 P55.0 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from P50-P61

Coder workflow for P55.0

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

Before you code P55.0

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with P55.0. 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 P55.0’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.

    ReviewQ44.3, E80.5, E80.6, E80.4

Consider P55.0. 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).

Official instructions as workflow

  • Excludes1 — check before selecting P55.0(5 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with P55.0: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareQ44.3, E80.5, E80.6, E80.4

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

Coding decision scenarios

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

Documentation: Both the condition P55.0 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewQ44.3, E80.5, E80.6, E80.4

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.

Don’t confuse P55.0 with…

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

The codes most likely to be picked instead of P55.0 — 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.

  • Q44.3— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

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

    What moves you there: Documentation of congenital stenosis and stricture of bile ducts moves the case to Q44.3; the two are not reported together unless documented as unrelated.

    Full comparison: P55.0 vs Q44.3 →

  • E80.5— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

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

    What moves you there: Documentation of Crigler-Najjar syndrome moves the case to E80.5; the two are not reported together unless documented as unrelated.

    Full comparison: P55.0 vs E80.5 →

  • E80.6— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

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

    What moves you there: Documentation of Dubin-Johnson syndrome moves the case to E80.6; the two are not reported together unless documented as unrelated.

    Full comparison: P55.0 vs E80.6 →

  • E80.4— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

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

    What moves you there: Documentation of Gilbert syndrome moves the case to E80.4; the two are not reported together unless documented as unrelated.

    Full comparison: P55.0 vs E80.4 →

  • D55— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

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

    What moves you there: Documentation of hereditary hemolytic anemias moves the case to D55; the two are not reported together unless documented as unrelated.

    Full comparison: P55.0 vs D55 →

  • D58— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

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

    What moves you there: Documentation of hereditary hemolytic anemias moves the case to D58; the two are not reported together unless documented as unrelated.

    Full comparison: P55.0 vs D58 →

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.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Rh isoimmunization of newborn is a billable ICD-10-CM diagnosis code (P55.0).

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

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-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name P55.0 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 5 Excludes1 notes across 4 chapters: D58 — Other hereditary hemolytic anemias (via P55.-), K72 — Hepatic failure, not elsewhere classified (via P55.-), P58 — Neonatal jaundice due to other excessive hemolysis (via P55.-), R71 — Abnormality of red blood cells (via P55.-), R76.0 — Raised antibody titer (via P55.-).

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

Referenced by 11 Excludes2 notes across 2 chapters: D59.1 — Other autoimmune hemolytic anemias (via P55.-), R70 — Elevated erythrocyte sedimentation rate and abnormality of plasma viscosity (via P55.-), R70-R79 — Abnormal findings on examination of blood, without diagnosis (R70-R79) (via P55.-), R71 — Abnormality of red blood cells (via P55.-), R73 — Elevated blood glucose level (via P55.-), R74 — Abnormal serum enzyme levels (via P55.-), R75 — Inconclusive laboratory evidence of human immunodeficiency virus [HIV] (via P55.-), R76 — Other abnormal immunological findings in serum (via P55.-), R77 — Other abnormalities of plasma proteins (via P55.-), R78 — Findings of drugs and other substances, not normally found in blood (via P55.-), R79 — Other abnormal findings of blood chemistry (via P55.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Code Also instruction: K76.82 — Hepatic encephalopathy (via P55.-).

These codes suggest coding this condition alongside when both are present.

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):PNL007 — Hemolytic jaundice and perinatal jaundice (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 CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Acquired Hemolytic, Aplastic, and Sideroblastic Anemias) for risk-adjusted payment.

D60.9 — Acquired pure red cell aplasia, unspecified, D61.01 — Constitutional (pure) red blood cell aplasia, D61.02 — Shwachman-Diamond syndrome, D61.03 — Fanconi anemia, D61.09 — Other constitutional aplastic anemia, D61.2 — Aplastic anemia due to other external agents, D61.3 — Idiopathic aplastic anemia, D61.818 — Other pancytopenia, D61.82 — Myelophthisis, D61.89 — Other specified aplastic anemias and other bone marrow failure syndromes, D64.0 — Hereditary sideroblastic anemia, D64.1 — Secondary sideroblastic anemia due to disease, D64.3 — Other sideroblastic anemias, D64.4 — Congenital dyserythropoietic anemia, P55.1 — ABO isoimmunization of newborn, P55.8 — Other hemolytic diseases of newborn, P55.9 — Hemolytic disease of newborn, unspecified, P56.0 — Hydrops fetalis due to isoimmunization, P56.90 — Hydrops fetalis due to unspecified hemolytic disease, P56.99 — Hydrops fetalis due to other hemolytic disease, +16 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Hemolytic jaundice and perinatal jaundice).

P55.1 — ABO isoimmunization of newborn, P55.8 — Other hemolytic diseases of newborn, P55.9 — Hemolytic disease of newborn, unspecified, P56.0 — Hydrops fetalis due to isoimmunization, P56.90 — Hydrops fetalis due to unspecified hemolytic disease, P56.99 — Hydrops fetalis due to other hemolytic disease, P57.0 — Kernicterus due to isoimmunization, P57.8 — Other specified kernicterus, P57.9 — Kernicterus, unspecified, P58.0 — Neonatal jaundice due to bruising, P58.1 — Neonatal jaundice due to bleeding, P58.2 — Neonatal jaundice due to infection, P58.3 — Neonatal jaundice due to polycythemia, P58.41 — Neonatal jaundice due to drugs or toxins transmitted from mother, P58.42 — Neonatal jaundice due to drugs or toxins given to newborn, P58.5 — Neonatal jaundice due to swallowed maternal blood, P58.8 — Neonatal jaundice due to other specified excessive hemolysis, P58.9 — Neonatal jaundice due to excessive hemolysis, unspecified, P59.0 — Neonatal jaundice associated with preterm delivery, P59.1 — Inspissated bile syndrome, +5 more

Same Index main term, other category

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

I67.89 — Other cerebrovascular disease (cerebral), K72.90 — Hepatic failure, unspecified without coma (malignant), K72.91 — Hepatic failure, unspecified with coma (malignant, with coma), K83.1 — Obstruction of bile duct (obstructive), O36.01 — Maternal care for anti-D [Rh] antibodies (Rh, affecting management of pregnancy NEC, anti-D antibody), O36.09 — Maternal care for other rhesus isoimmunization (Rh, affecting management of pregnancy NEC), O36.11 — Maternal care for Anti-A sensitization (affecting management of pregnancy), O36.19 — Maternal care for other isoimmunization (affecting management of pregnancy, specified NEC), O90.81 — Anemia of the puerperium (postpartum), P53 — Hemorrhagic disease of newborn (hemorrhagic, newborn), P56.0 — Hydrops fetalis due to isoimmunization (newborn, with, hydrops fetalis), P57.0 — Kernicterus due to isoimmunization (newborn, with, kernicterus), P57.9 — Kernicterus, unspecified (nuclear, newborn), P58.0 — Neonatal jaundice due to bruising (newborn, due to or associated with, bruising), P58.1 — Neonatal jaundice due to bleeding (newborn, due to or associated with, bleeding), P58.2 — Neonatal jaundice due to infection (newborn, due to or associated with, infection), P58.3 — Neonatal jaundice due to polycythemia (newborn, due to or associated with, polycythemia), P58.41 — Neonatal jaundice due to drugs or toxins transmitted from mother (newborn, due to or associated with, drugs or toxins, transmitted from mother), P58.42 — Neonatal jaundice due to drugs or toxins given to newborn (newborn, due to or associated with, drugs or toxins, given to newborn), P58.5 — Neonatal jaundice due to swallowed maternal blood (newborn, due to or associated with, swallowed maternal blood), +111 more

Contextual Map

Every relationship of P55.0 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 P55.0 with these 13 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes (11)

Referenced by Code Also instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 109 — Acquired Hemolytic, Aplastic, and Sideroblastic Anemias [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

Index entries (15)

  • Anemia (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound), newborn, due to, Rh (antibodies, isoimmunization, maternal/fetal incompatibility)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Antibodies, maternal (blood group), anti-D, newborn[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Disease, diseased, hemolytic (newborn), due to or with, incompatibility, Rh (blood group) (factor)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Disease, diseased, hemolytic (newborn), due to or with, Rh negative mother[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Erythroblastosis (fetalis) (newborn), due to, Rh (antibodies) (incompatibility) (isoimmunization)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Icterus, gravis, newborn[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Incompatibility, Rh (blood group) (factor), newborn[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Isoimmunization NEC, newborn, Rhesusfactor (Rh)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • and 7 more

Nearest codes

Change history

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

Reference

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

Indexed Clinical Terms (15)

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.

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
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release 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-derived 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 editorial 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 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial 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. "P55.0 — Rh isoimmunization of newborn." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/p55.0-rh-isoimmunization-of-newborn

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Rh isoimmunization of newborn

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 P55.0 in its code family, with their registry titles.

View all codes in the P55 family