2022 ICD-10-CM Code Z05.9
Observation and evaluation of newborn for unspecified suspected condition ruled out
Valid for Submission
| 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 |
Code Classification
Z05.9 is a billable diagnosis code used to specify a medical diagnosis of observation and evaluation of newborn for unspecified suspected condition ruled out. The code Z05.9 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
The ICD-10-CM code Z05.9 might also be used to specify conditions or terms like probable sars or suspected clinical finding. 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.
Unspecified diagnosis codes like Z05.9 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
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, ruled out - See Also: Suspected condition, ruled out;
- - condition NEC - Z03.89
- - newborn - See Also: Observation, newborn (for), suspected condition, ruled out; - Z05.9
- - condition NEC - Z03.89
- - newborn (for)
- - 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 - 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).
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Probable SARS
- Suspected clinical finding
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. 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 |
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 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code Z05.9 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.
- V29.9 - NB obsrv unsp suspct cnd (Approximate Flag)
Code History
- 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