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P74.0 ICD-10-CM Code: Late metabolic acidosis of newborn

Compare with another codeCheck 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
1 inclusion term · 1 Excludes1

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; the Instructions section marks which is which.

Excludes1Never report with this code
  • (fetal) metabolic acidosis of newborn (P19)
IncludesWhat this code covers
  • transitory endocrine and metabolic disturbances caused by the infant's response to maternal endocrine and metabolic factors, or its adjustment to extrauterine environment

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 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.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for P74.0 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 P74.0 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • transitory endocrine and metabolic disturbances caused by the infant's response to maternal endocrine and metabolic factors, or its adjustment to extrauterine environment

Source: inherited from P70-P74

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).

Coder workflow for P74.0

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

Before you code P74.0

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with P74.0. 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 P74.0’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.

    ReviewP19

Consider P74.0. 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 P74.0(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with P74.0: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareP19

    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 P74.0 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).

ReviewP19

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 P74.0 with…

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

The codes most likely to be picked instead of P74.0 — 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.

  • P19— 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 (fetal) metabolic acidosis of newborn moves the case to P19; the two are not reported together unless documented as unrelated.

    Full comparison: P74.0 vs P19 →

  • P74.9— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Transitory metabolic disturbance of newborn, unspecified” takes P74.9; specificity in the record moves it back here.

    Full comparison: P74.0 vs P74.9 →

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

Late metabolic acidosis of newborn is a billable ICD-10-CM diagnosis code (P74.0).

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

  • MCC as a secondary diagnosis (FY2027). 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-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name P74.0 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 1 Excludes1 note: P84 — Other problems with newborn.

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

Referenced by 2 Excludes2 notes: P00 — Newborn affected by maternal conditions that may be unrelated to present pregnancy (via P74.-), P74.421 — Hyperchloremia of newborn.

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

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 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 44 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):PNL013 — Other specified and unspecified perinatal conditions (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.

P70.9 — Transitory disorder of carbohydrate metabolism of newborn, unspecified, P71.0 — Cow's milk hypocalcemia in newborn, P71.1 — Other neonatal hypocalcemia, P71.2 — Neonatal hypomagnesemia, P71.3 — Neonatal tetany without calcium or magnesium deficiency, P71.4 — Transitory neonatal hypoparathyroidism, P71.8 — Other transitory neonatal disorders of calcium and magnesium metabolism, P71.9 — Transitory neonatal disorder of calcium and magnesium metabolism, unspecified, P72.1 — Transitory neonatal hyperthyroidism, P72.9 — Transitory neonatal endocrine disorder, unspecified, P74.1 — Dehydration of newborn, P74.21 — Hypernatremia of newborn, P74.22 — Hyponatremia of newborn, P74.31 — Hyperkalemia of newborn, P74.32 — Hypokalemia of newborn, P74.41 — Alkalosis of newborn, P74.421 — Hyperchloremia of newborn, P74.422 — Hypochloremia of newborn, P74.49 — Other transitory electrolyte disturbance of newborn, P74.9 — Transitory metabolic disturbance of newborn, unspecified, +23 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other specified and unspecified perinatal conditions).

P71.2 — Neonatal hypomagnesemia, P71.3 — Neonatal tetany without calcium or magnesium deficiency, P71.4 — Transitory neonatal hypoparathyroidism, P71.8 — Other transitory neonatal disorders of calcium and magnesium metabolism, P71.9 — Transitory neonatal disorder of calcium and magnesium metabolism, unspecified, P72.0 — Neonatal goiter, not elsewhere classified, P72.1 — Transitory neonatal hyperthyroidism, P72.2 — Other transitory neonatal disorders of thyroid function, not elsewhere classified, P72.8 — Other specified transitory neonatal endocrine disorders, P72.9 — Transitory neonatal endocrine disorder, unspecified, P74.1 — Dehydration of newborn, P74.2 — Disturbances of sodium balance of newborn, P74.21 — Hypernatremia of newborn, P74.22 — Hyponatremia of newborn, P74.3 — Disturbances of potassium balance of newborn, P74.31 — Hyperkalemia of newborn, P74.32 — Hypokalemia of newborn, P74.4 — Other transitory electrolyte disturbances of newborn, P74.41 — Alkalosis of newborn, P74.421 — Hyperchloremia of newborn, +74 more

Same Index main term, other category

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

P52.8 — Other intracranial (nontraumatic) hemorrhages of newborn (affected by, hemorrhage, intracranial, specified NEC), P52.9 — Intracranial (nontraumatic) hemorrhage of newborn, unspecified (affected by, hemorrhage, intracranial), P59.0 — Neonatal jaundice associated with preterm delivery (jaundice, of prematurity), P59.20 — Neonatal jaundice from unspecified hepatocellular damage (jaundice, due to, hepatocellular damage), P59.29 — Neonatal jaundice from other hepatocellular damage (jaundice, due to, hepatocellular damage, specified NEC), P59.3 — Neonatal jaundice from breast milk inhibitor (jaundice, due to, breast milk inhibitor), P59.8 — Neonatal jaundice from other specified causes (jaundice, specified NEC), P59.9 — Neonatal jaundice, unspecified (jaundice), P70.0 — Syndrome of infant of mother with gestational diabetes (affected by, maternal, gestational diabetes), P70.1 — Syndrome of infant of a diabetic mother (affected by, maternal, diabetes mellitus), P78.0 — Perinatal intestinal perforation (affected by, meconium peritonitis), P81.0 — Environmental hyperthermia of newborn (fever, environmentally-induced), P81.9 — Disturbance of temperature regulation of newborn, unspecified (fever), P83.4 — Breast engorgement of newborn (breast engorgement), P84 — Other problems with newborn (newborn), P90 — Convulsions of newborn (seizure), P91.0 — Neonatal cerebral ischemia (affected by, cerebral ischemia), P91.60 — Hypoxic ischemic encephalopathy [HIE], unspecified (affected by, hypoxic ischemic encephalopathy [HIE]), P91.61 — Mild hypoxic ischemic encephalopathy [HIE] (affected by, hypoxic ischemic encephalopathy [HIE], mild), P91.62 — Moderate hypoxic ischemic encephalopathy [HIE] (affected by, hypoxic ischemic encephalopathy [HIE], moderate), +154 more

Contextual Map

Every relationship of P74.0 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 P74.0 with these 4 related codes in Claim Check

Hierarchy

Excludes1

Referenced by Excludes1 notes

Referenced by Excludes2 notes

Clinical classification (CCSR)

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) · FY2027
  • DRG 791 — PREMATURITY WITH MAJOR PROBLEMS[MS-DRG]: “PREMATURITY WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
  • 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) · FY2027

MDC crossing

Index entries

  • Acidosis (lactic), metabolic NEC, late, of newborn[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Newborn (infant) (liveborn) (singleton), late metabolic acidosis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes (18)

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 (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.

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-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. "P74.0 — Late metabolic acidosis of newborn." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/p74.0-late-metabolic-acidosis-of-newborn

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Late metabolic acidosis 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 P74.0 in its code family, with their registry titles.

View all codes in the P74 family