ICD-10 Code Z05.1
Observation and evaluation of newborn for suspected infectious condition ruled out
Valid for Submission
Z05.1 is a billable code used to specify a medical diagnosis of observation and evaluation of newborn for suspected infectious condition ruled out. The code is valid for the year 2020 for the submission of HIPAA-covered transactions.
| ICD-10: | Z05.1 |
| Short Description: | Obs & eval of NB for suspected infect condition ruled out |
| Long Description: | Observation and evaluation of newborn for suspected infectious condition ruled out |
Code Classification
- Factors influencing health status and contact with health services (Z00–Z99)
Code History
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
Information for Medical Professionals
Code Edits
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
- Perinatal/Newborn diagnoses - Newborn. Age of 0 years; a subset of diagnoses intended only for newborns and neonates (e.g., fetal distress, perinatal jaundice).
Convert Z05.1 to ICD-9
The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:
- V29.0 - NB obsrv suspct infect (Approximate Flag)
Present on Admission (POA)
Z05.1 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement.
CMS POA Indicator Options and Definitions
| POA Indicator Code | POA Reason for Code | CMS will pay the CC/MCC DRG? |
|---|---|---|
| Y | Diagnosis was present at time of inpatient admission. | YES |
| N | Diagnosis was not present at time of inpatient admission. | NO |
| U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
| W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
| 1 | Unreported/Not used - Exempt from POA reporting. | NO |
Index to Diseases and Injuries
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code Z05.1 are found in the index:
Replacement Code
Z051 replaces the following previously assigned ICD-10 code(s):
- P00.2 - Newborn affected by maternal infec/parastc diseases
ICD-10 Footnotes
General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
- Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
- No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
- Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.