P05.04 Newborn light for gestational age, 1000-1249 grams

Billable ICD-10-CM code, FY2026.

Applies from P05.0 Newborn light for gestational age

Applicable to

• Newborn light-for-dates
• Weight below but length above 10th percentile for gestational age

MS-DRG index

Defines the logic of DRG(s) 794 in MDC 15.

Approximate ICD-9-CM (GEMs)

• 764.04 "Light-for-dates" without mention of fetal malnutrition, 1,000- 1,249 grams (approximate)

Code annotations containing back-references to P05.04

Back-references to P05.0

• Type 1 Excludes: P05.2 Newborn affected by fetal (intrauterine) malnutrition not light or small for gestational age ("newborn affected by fetal malnutrition with light for gestational age (P05.0-)")

Back-references to P05

• Type 1 Excludes: P07.0 Extremely low birth weight newborn ("low birth weight due to slow fetal growth and fetal malnutrition (P05.-)")
• Type 1 Excludes: P07.1 Other low birth weight newborn ("low birth weight due to slow fetal growth and fetal malnutrition (P05.-)")

Diagnosis Index entries for P05.04

• Light-for-dates (infant) › with weight of › 1000-1249 grams

Nearby codes

• P05.0 Newborn light for gestational age
• P05.00 Newborn light for gestational age, unspecified weight
• P05.01 Newborn light for gestational age, less than 500 grams
• P05.02 Newborn light for gestational age, 500-749 grams
• P05.03 Newborn light for gestational age, 750-999 grams
• P05.04 Newborn light for gestational age, 1000-1249 grams (this code)
• P05.05 Newborn light for gestational age, 1250-1499 grams
• P05.06 Newborn light for gestational age, 1500-1749 grams
• P05.07 Newborn light for gestational age, 1750-1999 grams
• P05.08 Newborn light for gestational age, 2000-2499 grams
• P05.09 Newborn light for gestational age, 2500 grams and over