ICD-10 Code Z05.9

Observation and evaluation of newborn for unspecified suspected condition ruled out

Version 2019 Billable Code Perinatal/newborn Diagnoses POA Exempt
ICD-10:Z05.9
Short Description:Obs & eval of NB for unsp suspected condition ruled out
Long Description:Observation and evaluation of newborn for unspecified suspected condition ruled out

Valid for Submission

ICD-10 Z05.9 is a billable code used to specify a medical diagnosis of observation and evaluation of newborn for unspecified suspected condition ruled out. The code is valid for the year 2019 for the submission of HIPAA-covered transactions.

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)

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 Z05.9 to ICD-9

The following crosswalk between ICD-10 to ICD-9 is based based on the General Equivalence Mappings (GEMS) information:

  • V29.9 - NB obsrv unsp suspct cnd (Approximate Flag)

Present on Admission (POA)

Z05.9 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 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

Synonyms

The following clinical terms are approximate synonyms:

  • Disease suspected
  • Glaucoma suspect
  • Glaucoma suspect
  • Probable SARS
  • Suspected bilateral glaucoma
  • Suspected brain tumor
  • Suspected central nervous system cancer
  • Suspected chromosome abnormality
  • Suspected clinical finding
  • Suspected coronavirus infection
  • Suspected cystic fibrosis
  • Suspected dengue
  • Suspected Downs syndrome
  • Suspected glaucoma of bilateral eyes caused by steroids
  • Suspected glaucoma of left eye
  • Suspected glaucoma of left eye caused by steroids
  • Suspected glaucoma of right eye
  • Suspected glaucoma of right eye caused by steroids
  • Suspected head and neck cancer
  • Suspected heart disease
  • Suspected heart failure
  • Suspected neuroblastoma
  • Suspected neurological disease
  • Suspected pressure injury of deep tissue
  • Suspected pulmonary embolism
  • Suspected respiratory disease
  • Suspected respiratory disease
  • Suspected respiratory disease
  • Suspected sarcoma
  • Suspected SARS
  • Suspected upper gastrointestinal cancer

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 Z05.9 are found in the index:


Replacement Code

Z059 replaces the following previously assigned ICD-10 code(s):

  • P00.9 - Newborn affected by unsp maternal condition
  • P00.9 - Newborn affected by unspecified maternal condition

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.