ICD-10: Clinical Concepts for Pediatrics
The health care industry has seen the largest update to ICD-10 post the five-year code freeze. It is important to review the updated addenda to ensure you have all the code changes in your fingertips.
Following are some examples of how to use a few of the new ICD-10 codes for pediatrics.
Updates to Perinatal Coding Issues
A 12-day-old patient presents to the pediatrics office. The mom made the appointment because she is convinced the baby has stopped breathing from time to time. After taking the history, performing the exam and witnessing what the mom thought was an apneic spell, the physician determines the baby is fine. He counsels the mom on what to look for and reassures her that what she was seeing is normal.
Report code Z05.3 Observation and evaluation of newborn for suspected respiratory condition ruled out. This is a new category of codes that can be used in the neonatal period to define encounters when the condition thought to be present is ruled out.
A baby is born at term gestation to a mother with suspected chorioamnionitis who was febrile during labor. The baby is asymptomatic and has a blood culture performed along with complete blood count and differential. Broad spectrum antibiotics are initiated pending lab results. After 48 hours of negative blood culture, the baby’s antibiotics are discontinued.
Report the following codes for each day:
- Day 1 P02.7 Newborn affected by chorioamnionitis
- Day 2 P02.7 Newborn affected by chorioamnionitis
- Day 3 Z05.1 Observation and evaluation of newborn for suspected infectious condition ruled out
If you plan to code or bill only on the day of discharge, report Z05.1.
Other Medical Issues
- A 4-year-old patient presents to the office with facial swelling near the left eye. The physician examines the patient and determines he has periorbital cellulitis. Due to severity of this condition, the physician decides to admit the child for antibiotic therapy.
- Report code L03.213 Periorbital cellulitis. This new code was added because the current code set did not have a specific code for the severity of this condition.
- A 6-week-old presents for the first time to the office. Upon exam, a sacral dimple is noted, and the physician documents this for possible follow-up services.
- Report code Q82.6 Congenital sacral dimple.
For more updates and a review of ICD-10 for Pediatrics, take part in the year’s biggest online conference on coding updates – Virtual Boot Camp. This session will be presented by renowned coding expert Donelle Holle. This session will update you on the newest ICD-10 codes that will affect Pediatrics and review how to properly use diagnosis codes to enable accurate reimbursement.