- ICD-10-CM Index
- Chapter: Z00–Z99
- Section: Z00-Z13
- Block: Z05
- Z05.1 - Obs & eval of NB for suspected infect condition ruled out
Valid for Submission
Z05.1 is a billable diagnosis code used to specify a medical diagnosis of observation and evaluation of newborn for suspected infectious condition ruled out. The code Z05.1 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
The code Z05.1 is applicable to newborn patients only. It is clinically and virtually impossible to use this code on a non-newborn patient.
|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|
Factors influencing health status and contact with health services (Z00–Z99)
Persons encountering health services for examinations (Z00-Z13)
Enctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
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:
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 - The Medicare Code Editor detects inconsistencies in perinatal / newborn cases by checking a patient's age and any diagnosis on the patient's record. The newborn code edits apply to patients age 0 years only; a subset of diagnoses which will only occur during the perinatal or newborn period of age 0 (e.g., tetanus neonatorum, health examination for newborn under 8 days old).
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. Review other POA exempt codes here .
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|
Z051 replaces the following previously assigned ICD-10 code(s):
- P00.2 - Newborn affected by maternal infec/parastc diseases
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code Z05.1 its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
- V29.0 - NB obsrv suspct infect (Approximate Flag)
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018