ICD-10-CM Code Z38.1

Single liveborn infant, born outside hospital

Version 2020 Billable Code Perinatal/newborn Diagnoses POA Exempt

Valid for Submission

Z38.1 is a billable code used to specify a medical diagnosis of single liveborn infant, born outside hospital. The code is valid for the year 2020 for the submission of HIPAA-covered transactions. The ICD-10-CM code Z38.1 might also be used to specify conditions or terms like born at home, born before arrival, born before arrival of midwife, born before arrival to hospital, born in ambulance, livebirth born before admission to hospital, etc The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.

The code Z38.1 is applicable to newborn patients only. It is clinically and virtually impossible to use this code on a non-newborn patient.

ICD-10:Z38.1
Short Description:Single liveborn infant, born outside hospital
Long Description:Single liveborn infant, born outside hospital

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 Z38.1 are found in the 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:

  • 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:

  • Born at home
  • Born before arrival
  • Born before arrival of midwife
  • Born before arrival to hospital
  • Born in ambulance
  • Livebirth born before admission to hospital
  • Singleton liveborn born outside hospital

Present on Admission (POA)

Z38.1 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.

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

Convert Z38.1 to ICD-9

  • V30.1 - Singl livebrn-before adm (Approximate Flag)
  • V30.2 - Single liveborn-nonhosp (Approximate Flag)
  • V39.1 - Liveborn NOS-before adm (Approximate Flag)
  • V39.2 - Liveborn NOS-nonhosp (Approximate Flag)

Code Classification

  • Factors influencing health status and contact with health services (Z00–Z99)
    • Persons encountering health services in circumstances related to reproduction (Z30-Z39)
      • Liveborn infants according to place of birth and type of del (Z38)

Code History

  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016
    (First year ICD-10-CM implemented into the HIPAA code set)
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • 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

Information for Patients


Childbirth

When you are ready to have your baby, you'll go through labor. Labor is the process of giving birth. Signs that you might be going into labor include

  • Contractions that are regular then start to come closer together
  • Leaking fluid or bleeding from the vagina
  • Low, dull backache
  • Abdominal cramps

Call your health care provider if you have any of these signs, even if it is before your due date. Preterm labor can start before 37 completed weeks of pregnancy.

Labor happens in three stages. The first stage begins with contractions. It continues until your cervix has become thinner and dilated (stretched) to about 4 inches wide. The second stage is the active stage, in which you begin to push downward. Crowning is when your baby's scalp comes into view. Shortly afterward, your baby is born. In the third stage, you deliver the placenta. The placenta is the organ that supplied food and oxygen to your baby during pregnancy.

Mothers and babies are monitored closely during labor. Most women are able to have a baby through normal vaginal delivery. If there are complications, the baby may need to be delivered surgically by a Cesarean section.

NIH: National Institute of Child Health and Human Development


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