Mary Jo Bowie MS, BS, AAS, RHIA, RHIT

Certain Conditions Originating in the Perinatal Period CHAPTER 21 Certain Conditions Originating in the Perinatal Period

Certain Conditions Originating in the Perinatal Period—Code Range P00-P96 Certain conditions originating in the perinatal period are reported from Chapter 16 of ICD-10-CM. This chapter contains codes for certain conditions originating in the perinatal period and are for use on newborn records only.

Start of Chapter 16 in ICD-10-CM Coders need to read the start of Chapter 16 of ICD-10-CM to become familiar with the notations that are present. The perinatal period is defined as before birth through the first 28 days after birth.

Newborn Affected by Maternal Factors and Complications of Pregnancy, Labor, and Delivery—P00-P04 An extensive note appears at the start of this block of codes. The code descriptions are very detailed in this block and must be read carefully.

Disorders of Newborn Related to Length of Gestation and Fetal Growth—P05-P08 This block of codes reports disorders such as: Newborn light or small for gestational age Disorders related to short gestation and low birth weight Disorders of newborn related to long gestation and high birth weight

Abnormal Findings on Neonatal Screening—P09 This category reports abnormal findings on neonatal screening. Coders are instructed to use an additional code to identify signs, symptoms, and conditions associated with the screening.

Birth Trauma—P10-P15 This block of codes reports: Intracranial laceration and hemorrhage due to birth injury Birth injuries of the central nervous system Birth injuries of the scalp Birth injuries to skeleton Birth injuries to peripheral nervous system Birth injuries to other sites

Respiratory and Cardiovascular Disorders Specific to the Perinatal Period—P19-P29 This block of codes reports: Metabolic acidemia in newborn Congenital pneumonia Neonatal aspirations Respiratory and cardiovascular conditions originating in the perinatal period

Infections Specific to the Perinatal Period—P35-P39 The categories here include: P35—Congenital viral diseases P36—Bacterial sepsis of newborn P37—Other congenital infectious and parasitic diseases such as tubercuolsis, malaria, and candidiasis P38—Omphalitis of newborn P39—Other infections specific to the perinatal period, such as neonatal- mastitis, UTI, conjunctivitis, and skin infections

Hemorrhagic and Hematological Disorders of Newborn—P50-P61 These categories report: Newborn affected by intrauterine blood loss Umbilical hemorrhage of newborn Intracranial nontraumatic hemorrhage of newborn Hemorrhagic disease of newborn Hemolytic disease of newborn Hydrops fetalis due to hemolytic disease Kernicterus Neonatal jaundice Hematoloigcal disorders

Transitory Endocrine and Metabolic Disorders Specific to Newborn—P70-P74 This block reports transitory endocrine and metabolic disturbances caused by the infant’s response to maternal endocrine and metabolic factors, or its adjustment to extrauterine environment.

Digestive System Disorder of Newborn—P76-P78 This block reports: Meconium plug syndrome Intestinal obstruction due to inspissated milk Necrotizing enterocolitis of newborn Perinatal intestinal perforation Neonatal hematemesis and melana Noninfective neonatal diarrhea

Conditions Involving the Integument and Temperature Regulation of Newborn—P80-P83 This block reports: Hypothermia of newborn Other disturbances of temperature Other conditions of integument specific to newborn such as congenital hydrocele, umbilical polyp and neonatal scleroderma

Other Problems with Newborn—P84 This block reports the following conditions of newborns: Acidemia Acidosis Anoxia Asphyxia Hypercapnia Hypoxemia and hypoxia Mixed metabolic and respiratory acidosis

Other Disorders Originating in the Perinatal Period—P90-P96 This block reports the following conditions for newborns: Convulsions Feeding problems Reactions and intoxications due to drugs administered Disorders of muscle tone Stillbirth Renal conditions including renal failure Neonatal withdrawal symptoms Complication to newborn due to intrauterine procedures

Official Guidelines for Coding and Reporting The guidelines address the following: General perinatal rules Observation and evaluation of newborns for suspected conditions not found Coding additional perinatal diagnoses Prematurity and fetal growth retardation Low birth weight and immaturity status Bacterial sepsis of newborn Stillbirth

Coding Practice Select the code for the following: Transitory neonatal hypoglycemia

Coding Practice Solution Main term to reference in index: Hypoglycemia Modifying term: Neonatal (transitory) Code Assignment: P70.4