Name: Kernicterus, unspecified
Creator: MedCoder.ai

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

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 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
MS-DRG 793 — FULL TERM NEONATE WITH MAJOR 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 192 — Cerebral Palsy, Except Quadriplegic

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 P57.9 in the official ICD-10-CM tabular list, quoted as published.

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

Notes without a marker are published on P57.9 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).

congenital stenosis and stricture of bile ducts (Q44.3) Compare P57.9 vs Q44.3 →
Crigler-Najjar syndrome (E80.5) Compare P57.9 vs E80.5 →
Dubin-Johnson syndrome (E80.6) Compare P57.9 vs E80.6 →
Gilbert syndrome (E80.4) Compare P57.9 vs E80.4 →
hereditary hemolytic anemias (D55-D58) Compare P57.9 vs D55 →

Source: inherited from P50-P61

Coder workflow for P57.9

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

Before you code P57.9

Unspecified does not mean incorrect. When the record gives no greater specificity, P57.9 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).
ReviewP57.0, P57.8
See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →
Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with P57.9. 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

Does the record document the detail a more specific sibling code needs?
Yes → Review the specific siblings in this subcategory.
No → Continue — P57.9 is appropriate when the documentation goes no further.
ReviewP57.0, P57.8
Does the documentation support a condition named in P57.9’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 P57.9. 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

Excludes1 — check before selecting P57.9(5 notes)
Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with P57.9: 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: 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).

ReviewP57.0, P57.8

Documentation: Both the condition P57.9 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.

Code Overview

Kernicterus, unspecified is a billable ICD-10-CM diagnosis code (P57.9).

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 (4)

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.

Don’t confuse P57.9 with…

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

The codes most likely to be picked instead of P57.9 — 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.

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: P57.9 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: P57.9 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: P57.9 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: P57.9 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: P57.9 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: P57.9 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.

Verify Before Coding

MCC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

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 P57.9 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 4 Excludes1 notes across 3 chapters: K72 — Hepatic failure, not elsewhere classified (via P57.-), P58 — Neonatal jaundice due to other excessive hemolysis (via P57.-), P59 — Neonatal jaundice from other and unspecified causes (via P57.-), R17 — Unspecified jaundice (via P57.-).

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

Referenced by 10 Excludes2 notes: R70 — Elevated erythrocyte sedimentation rate and abnormality of plasma viscosity (via P57.-), R70-R79 — Abnormal findings on examination of blood, without diagnosis (R70-R79) (via P57.-), R71 — Abnormality of red blood cells (via P57.-), R73 — Elevated blood glucose level (via P57.-), R74 — Abnormal serum enzyme levels (via P57.-), R75 — Inconclusive laboratory evidence of human immunodeficiency virus [HIV] (via P57.-), R76 — Other abnormal immunological findings in serum (via P57.-), R77 — Other abnormalities of plasma proteins (via P57.-), R78 — Findings of drugs and other substances, not normally found in blood (via P57.-), R79 — Other abnormal findings of blood chemistry (via P57.-).

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

Referenced by 1 Code First instruction: P91.811 — Neonatal encephalopathy in diseases classified elsewhere (via P57.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Referenced by 1 Code Also instruction: K76.82 — Hepatic encephalopathy (via P57.-).

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

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: MCC — Major Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 35 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 2 MS-DRGs: DRG 791 (MDC 15), DRG 793 (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 clinical process (MS-DRG)

Acts as MCC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Cerebral Palsy, Except Quadriplegic) for risk-adjusted payment.

G80.1 — Spastic diplegic cerebral palsy, G80.2 — Spastic hemiplegic cerebral palsy, G80.3 — Athetoid cerebral palsy, G80.4 — Ataxic cerebral palsy, G80.8 — Other cerebral palsy, G80.9 — Cerebral palsy, unspecified, P57.0 — Kernicterus due to isoimmunization, P57.8 — Other specified kernicterus

Same clinical category (CCSR)

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

Same Index main term, other category

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

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

Contextual Map

Every relationship of P57.9 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.

Run P57.9 with these 14 related codes in Claim Check

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
P50-P61 — Hemorrhagic and hematological disorders of newborn[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Referenced by Excludes1 notes

K72 — Hepatic failure, not elsewhere classified[Excludes1](via P57.-): “icterus of newborn (P55-P59)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
P58 — Neonatal jaundice due to other excessive hemolysis[Excludes1](via P57.-): “jaundice due to isoimmunization (P55-P57)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
P59 — Neonatal jaundice from other and unspecified causes[Excludes1](via P57.-): “kernicterus (P57.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
R17 — Unspecified jaundice[Excludes1](via P57.-): “neonatal jaundice (P55, P57-P59)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes (10)

R70 — Elevated erythrocyte sedimentation rate and abnormality of plasma viscosity[Excludes2](via P57.-): “hemorrhagic and hematological disorders of newborn (P50-P61)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
R70-R79 — Abnormal findings on examination of blood, without diagnosis (R70-R79)[Excludes2](via P57.-): “hemorrhagic and hematological disorders of newborn (P50-P61)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
R71 — Abnormality of red blood cells[Excludes2](via P57.-): “hemorrhagic and hematological disorders of newborn (P50-P61)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
R73 — Elevated blood glucose level[Excludes2](via P57.-): “hemorrhagic and hematological disorders of newborn (P50-P61)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
R74 — Abnormal serum enzyme levels[Excludes2](via P57.-): “hemorrhagic and hematological disorders of newborn (P50-P61)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
R75 — Inconclusive laboratory evidence of human immunodeficiency virus [HIV][Excludes2](via P57.-): “hemorrhagic and hematological disorders of newborn (P50-P61)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
R76 — Other abnormal immunological findings in serum[Excludes2](via P57.-): “hemorrhagic and hematological disorders of newborn (P50-P61)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
R77 — Other abnormalities of plasma proteins[Excludes2](via P57.-): “hemorrhagic and hematological disorders of newborn (P50-P61)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
and 2 more

Referenced by Code First instructions

P91.811 — Neonatal encephalopathy in diseases classified elsewhere[Code First](via P57.-): “kernicterus (P57.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Code Also instructions

K76.82 — Hepatic encephalopathy[Code Also](via P57.-): “icterus of newborn (P55-P59)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

PNL007 — Hemolytic jaundice and perinatal jaundice[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

Risk adjustment (CMS-HCC)

HCC 192 — Cerebral Palsy, Except Quadriplegic [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MCC — Major Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (MCC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2026
DRG 791 — PREMATURITY WITH MAJOR PROBLEMS[MS-DRG]: “PREMATURITY WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS[MS-DRG]: “FULL TERM NEONATE WITH MAJOR PROBLEMS (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

Encephalopathia hyperbilirubinemica, newborn[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Encephalopathy (acute), hyperbilirubinemic, newborn[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Jaundice (yellow), nuclear, newborn[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Kernicterus of newborn (not due to isoimmunization)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes

P57 — Kernicterus[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
P57.0 — Kernicterus due to isoimmunization[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
P57.8 — Other specified kernicterus[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

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
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 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. "P57.9 — Kernicterus, unspecified." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/p57.9-kernicterus-unspecified

Change history

FY2016 — October 1, 2015
In the code set at ICD-10-CM adoption
Kernicterus, unspecified

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 P57.9 in its code family, with their registry titles.

View all codes in the P57 family

P57.9 ICD-10-CM Code: Kernicterus, unspecified

Coding at a Glance

Inpatient Payment Groups (MS-DRG)

Risk Adjustment (CMS-HCC)

Coding instructions

Excludes1 — Not Coded Here

Coder workflow for P57.9

Before you code P57.9

Choose the right path

Documentation check

Official instructions as workflow

Coding decision scenarios

Code Overview

Indexed Clinical Terms (4)

Don’t confuse P57.9 with…

Verify Before Coding

Relationships & Classification

MS-DRG Grouper Relationships (FY2026)

Related Codes

Same clinical process (MS-DRG)

Same CMS-HCC risk category (V28)

Same clinical category (CCSR)

Same Index main term, other category

Lab tests where this diagnosis supports Medicare coverage (NCD)

Contextual Map

Hierarchy

Referenced by Excludes1 notes

Referenced by Excludes2 notes (10)

Referenced by Code First instructions

Referenced by Code Also instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

MS-DRG Grouper

MDC crossing

Index entries

Nearest codes

Change history

Sources for this page

Cite this page

Change history

Nearest Codes in This Family