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Perinatal / Newborn diagnoses - ICD-10-CM Medicare Code Edits

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).

The following 42 ICD-10-CM codes are intended for perinatal / newborn diagnoses

  • Tetanus neonatorum (A33)

    • A33 - Tetanus neonatorum

  • Cystic fibrosis (E84)

    • E84.11 - Meconium ileus in cystic fibrosis

  • Disorders of lacrimal system (H04)

    • H04.531 - Neonatal obstruction of right nasolacrimal duct

    • H04.532 - Neonatal obstruction of left nasolacrimal duct

    • H04.533 - Neonatal obstruction of bilateral nasolacrimal duct

    • H04.539 - Neonatal obstruction of unspecified nasolacrimal duct

  • Disorders of prepuce (N47)

    • N47.0 - Adherent prepuce, newborn

  • Encounter for general examination without complaint, suspected or reported diagnosis (Z00)

    • Z00.110 - Health examination for newborn under 8 days old

    • Z00.111 - Health examination for newborn 8 to 28 days old

  • Encounter for observation and evaluation of newborn for suspected diseases and conditions ruled out (Z05)

    • Z05.0 - Observation and evaluation of newborn for suspected cardiac condition ruled out

    • Z05.1 - Observation and evaluation of newborn for suspected infectious condition ruled out

    • Z05.2 - Observation and evaluation of newborn for suspected neurological condition ruled out

    • Z05.3 - Observation and evaluation of newborn for suspected respiratory condition ruled out

    • Z05.41 - Observation and evaluation of newborn for suspected genetic condition ruled out

    • Z05.42 - Observation and evaluation of newborn for suspected metabolic condition ruled out

    • Z05.43 - Observation and evaluation of newborn for suspected immunologic condition ruled out

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

    • Z05.6 - Observation and evaluation of newborn for suspected genitourinary condition ruled out

    • Z05.71 - Observation and evaluation of newborn for suspected skin and subcutaneous tissue condition ruled out

    • Z05.72 - Observation and evaluation of newborn for suspected musculoskeletal condition ruled out

    • Z05.73 - Observation and evaluation of newborn for suspected connective tissue condition ruled out

    • Z05.81 - Observation and evaluation of newborn for suspected condition related to home physiologic monitoring device ruled out

    • Z05.89 - Observation and evaluation of newborn for other specified suspected condition ruled out

    • Z05.9 - Observation and evaluation of newborn for unspecified suspected condition ruled out

  • Liveborn infants according to place of birth and type of delivery (Z38)

    • Z38.00 - Single liveborn infant, delivered vaginally

    • Z38.01 - Single liveborn infant, delivered by cesarean

    • Z38.1 - Single liveborn infant, born outside hospital

    • Z38.2 - Single liveborn infant, unspecified as to place of birth

    • Z38.30 - Twin liveborn infant, delivered vaginally

    • Z38.31 - Twin liveborn infant, delivered by cesarean

    • Z38.4 - Twin liveborn infant, born outside hospital

    • Z38.5 - Twin liveborn infant, unspecified as to place of birth

    • Z38.61 - Triplet liveborn infant, delivered vaginally

    • Z38.62 - Triplet liveborn infant, delivered by cesarean

    • Z38.63 - Quadruplet liveborn infant, delivered vaginally

    • Z38.64 - Quadruplet liveborn infant, delivered by cesarean

    • Z38.65 - Quintuplet liveborn infant, delivered vaginally

    • Z38.66 - Quintuplet liveborn infant, delivered by cesarean

    • Z38.68 - Other multiple liveborn infant, delivered vaginally

    • Z38.69 - Other multiple liveborn infant, delivered by cesarean

    • Z38.7 - Other multiple liveborn infant, born outside hospital

    • Z38.8 - Other multiple liveborn infant, unspecified as to place of birth