P91.5 ICD-10-CM Code: Neonatal coma

Indexed Clinical Terms (1)

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.

• Coma, newborn

Don’t confuse P91.5 with…

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

The codes most likely to be picked instead of P91.5 — 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.

• P91.9— 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 “Disturbance of cerebral status of newborn, unspecified” takes P91.9; specificity in the record moves it back here.

  Full comparison: P91.5 vs P91.9 →

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.

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 P91.5 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 2 Excludes1 notes across 2 chapters: P91.6 — Hypoxic ischemic encephalopathy [HIE], R40 — Somnolence, stupor and coma.

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

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 13 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):PNL004 — Neonatal cerebral disorders (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.

P90 — Convulsions of newborn, P91.0 — Neonatal cerebral ischemia, P91.1 — Acquired periventricular cysts of newborn, P91.3 — Neonatal cerebral irritability, P91.4 — Neonatal cerebral depression, P91.819 — Neonatal encephalopathy, unspecified, P91.821 — Neonatal cerebral infarction, right side of brain, P91.822 — Neonatal cerebral infarction, left side of brain, P91.823 — Neonatal cerebral infarction, bilateral, P91.829 — Neonatal cerebral infarction, unspecified side, P91.88 — Other specified disturbances of cerebral status of newborn, P91.9 — Disturbance of cerebral status of newborn, unspecified

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Coma, Brain Compression/Anoxic Damage) for risk-adjusted payment.

E03.5 — Myxedema coma, G93.1 — Anoxic brain damage, not elsewhere classified, G93.5 — Compression of brain, G93.6 — Cerebral edema, P91.0 — Neonatal cerebral ischemia, P91.1 — Acquired periventricular cysts of newborn, P91.2 — Neonatal cerebral leukomalacia, P91.3 — Neonatal cerebral irritability, P91.4 — Neonatal cerebral depression, P91.60 — Hypoxic ischemic encephalopathy [HIE], unspecified, P91.61 — Mild hypoxic ischemic encephalopathy [HIE], P91.62 — Moderate hypoxic ischemic encephalopathy [HIE], P91.63 — Severe hypoxic ischemic encephalopathy [HIE], P91.811 — Neonatal encephalopathy in diseases classified elsewhere, P91.819 — Neonatal encephalopathy, unspecified, P91.88 — Other specified disturbances of cerebral status of newborn, P91.9 — Disturbance of cerebral status of newborn, unspecified, R40.20 — Unspecified coma, R40.2110 — Coma scale, eyes open, never, unspecified time, R40.2111 — Coma scale, eyes open, never, in the field [EMT or ambulance], +40 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Major Head Injury with Loss of Consciousness > 1 Hour, Major Head Injury with Loss of Consciousness < 1 Hour or Unspecified, Chronic Liver Failure/End-Stage Liver Disorders

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Neonatal cerebral disorders).

P90 — Convulsions of newborn, P91.0 — Neonatal cerebral ischemia, P91.1 — Acquired periventricular cysts of newborn, P91.2 — Neonatal cerebral leukomalacia, P91.3 — Neonatal cerebral irritability, P91.4 — Neonatal cerebral depression, P91.60 — Hypoxic ischemic encephalopathy [HIE], unspecified, P91.61 — Mild hypoxic ischemic encephalopathy [HIE], P91.62 — Moderate hypoxic ischemic encephalopathy [HIE], P91.63 — Severe hypoxic ischemic encephalopathy [HIE], P91.8 — Other specified disturbances of cerebral status of newborn, P91.811 — Neonatal encephalopathy in diseases classified elsewhere, P91.819 — Neonatal encephalopathy, unspecified, P91.821 — Neonatal cerebral infarction, right side of brain, P91.822 — Neonatal cerebral infarction, left side of brain, P91.823 — Neonatal cerebral infarction, bilateral, P91.829 — Neonatal cerebral infarction, unspecified side, P91.88 — Other specified disturbances of cerebral status of newborn, P91.9 — Disturbance of cerebral status of newborn, unspecified

Same Index main term, other category

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

E03.5 — Myxedema coma (myxedematous), E15 — Nondiabetic hypoglycemic coma (hypoglycemic, nondiabetic), R40.20 — Unspecified coma, R40.211 — Coma scale, eyes open, never (with, opening of eyes), R40.212 — Coma scale, eyes open, to pain (with, opening of eyes, score of, 2), R40.213 — Coma scale, eyes open, to sound (with, opening of eyes, score of, 3), R40.214 — Coma scale, eyes open, spontaneous (with, opening of eyes, score of, 4), R40.221 — Coma scale, best verbal response, none (with, verbal response), R40.222 — Coma scale, best verbal response, incomprehensible words (with, verbal response, score of, 2), R40.223 — Coma scale, best verbal response, inappropriate words (with, verbal response, screaming), R40.224 — Coma scale, best verbal response, confused conversation (with, verbal response, score of, 4), R40.225 — Coma scale, best verbal response, oriented (with, verbal response, oriented), R40.231 — Coma scale, best motor response, none (with, motor response), R40.232 — Coma scale, best motor response, extension (with, motor response, extension), R40.233 — Coma scale, best motor response, abnormal flexion (with, motor response, abnormal), R40.234 — Coma scale, best motor response, flexion withdrawal (with, motor response, score of, 4), R40.235 — Coma scale, best motor response, localizes pain (with, motor response, score of, 5), R40.236 — Coma scale, best motor response, obeys commands (with, motor response, score of, 6), R40.244 — Other coma, without documented Glasgow coma scale score, or with partial score reported (specified NEC, without documented Glasgow coma scale score, or with partial Glasgow coma scale score reported), R40.2A — Nontraumatic coma due to underlying condition (secondary), +1 more

Contextual Map

Every relationship of P91.5 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 P91.5 with these 2 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
• P90-P96 — Other disorders originating in the perinatal period[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Referenced by Excludes1 notes

• P91.6 — Hypoxic ischemic encephalopathy [HIE][Excludes1]: “Neonatal coma (P91.5)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R40 — Somnolence, stupor and coma[Excludes1]: “neonatal coma (P91.5)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• PNL004 — Neonatal cerebral disorders[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

Risk adjustment (CMS-HCC)

• HCC 202 — Coma, Brain Compression/Anoxic Damage [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

• Coma, newborn[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (22)

• P91 — Other disturbances of cerebral status of newborn[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P91.0 — Neonatal cerebral ischemia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P91.1 — Acquired periventricular cysts of newborn[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P91.2 — Neonatal cerebral leukomalacia[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P91.3 — Neonatal cerebral irritability[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P91.4 — Neonatal cerebral depression[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P91.6 — Hypoxic ischemic encephalopathy [HIE][Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• P91.60 — Hypoxic ischemic encephalopathy [HIE], unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 14 more

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

Nearest Codes in This Family

Official ICD-10-CM classifications closest to P91.5 in its code family, with their registry titles.

• P91.0 — Neonatal cerebral ischemia
• P91.1 — Acquired periventricular cysts of newborn
• P91.2 — Neonatal cerebral leukomalacia
• P91.3 — Neonatal cerebral irritability
• P91.4 — Neonatal cerebral depression
• P91.6 — Hypoxic ischemic encephalopathy [HIE]
• P91.60 — Hypoxic ischemic encephalopathy [HIE], unspecified
• P91.61 — Mild hypoxic ischemic encephalopathy [HIE]
• P91.62 — Moderate hypoxic ischemic encephalopathy [HIE]
• P91.63 — Severe hypoxic ischemic encephalopathy [HIE]

View all codes in the P91 family