Z05.5 - Observation and evaluation of newborn for suspected gastrointestinal condition ruled out

Version 2023
ICD-10:Z05.5
Short Description:Obs & eval of NB for suspected GI condition ruled out
Long Description:Observation and evaluation of newborn for suspected gastrointestinal condition ruled out
Status: Valid for Submission
Version:ICD-10-CM 2023
Code Classification:
  • 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)

Z05.5 is a billable ICD-10 code used to specify a medical diagnosis of observation and evaluation of newborn for suspected gastrointestinal condition ruled out. The code is valid during the fiscal year 2023 from October 01, 2022 through September 30, 2023 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 Z05.5 is applicable to newborn patients only. It is clinically and virtually impossible to use this code on a non-newborn patient.

Index to Diseases and Injuries References

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 this diagnosis code are found in the injuries and diseases index:

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:

Present on Admission (POA)

Z05.5 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 CodePOA Reason for CodeCMS will pay the CC/MCC DRG?
YDiagnosis was present at time of inpatient admission.YES
NDiagnosis was not present at time of inpatient admission.NO
UDocumentation insufficient to determine if the condition was present at the time of inpatient admission.NO
WClinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission.YES
1Unreported/Not used - Exempt from POA reporting. NO

Replacement Code

Z055 replaces the following previously assigned ICD-10 code(s):

Convert to ICD-9 Code

Source ICD-10 CodeTarget ICD-9 Code
Z05.5V29.8 - NB obsrv oth suspct cond
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Code History