ICD-10-CM Code Z05.9

Valid for Submission

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 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z05.9 might also be used to specify conditions or terms like disease suspected, glaucoma suspect, glaucoma suspect, probable sars , suspected benign pigmented skin lesion, suspected bilateral glaucoma, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z05.9 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

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:

• - Observation (following) (for) (without need for further medical care) - Z04.9
  • - newborn (for)
    • - suspected condition, related to exposure from the mother or birth process - See: - Newborn, affected by, maternal;
      • - ruled out - Z05.9
  • - suspected, ruled out - See Also: Suspected condition, ruled out;
    • - condition NEC - Z03.89
      • - newborn - See Also: Observation, newborn (for), suspected condition, ruled out; - Z05.9

• - Suspected condition, ruled out - See Also: Observation, suspected;
  • - newborn - See Also: Observation, newborn, suspected condition ruled out; - Z05.9

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).

Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Disease suspected
• Glaucoma suspect
• Glaucoma suspect
• Probable SARS
• Suspected benign pigmented skin lesion
• 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 malignant pigmented skin lesion
• Suspected neuroblastoma
• Suspected neurological disease
• Suspected pressure injury of deep tissue
• Suspected pulmonary embolism
• Suspected respiratory disease
• Suspected respiratory disease
• Suspected sarcoma
• Suspected SARS
• Suspected soft tissue infection
• Suspected upper gastrointestinal cancer
• Suspected viral infection of skin

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.

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

Convert Z05.9 to ICD-9

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

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)

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

Tools

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• Convert Z05.9 to ICD-9