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

ICD CodeDescriptionCategory
A33Tetanus neonatorumTetanus neonatorum (A33)
E84.11Meconium ileus in cystic fibrosisCystic fibrosis (E84)
H04.531Neonatal obstruction of right nasolacrimal ductDisorders of lacrimal system (H04)
H04.532Neonatal obstruction of left nasolacrimal ductDisorders of lacrimal system (H04)
H04.533Neonatal obstruction of bilateral nasolacrimal ductDisorders of lacrimal system (H04)
H04.539Neonatal obstruction of unspecified nasolacrimal ductDisorders of lacrimal system (H04)
N47.0Adherent prepuce, newbornDisorders of prepuce (N47)
Z00.110Health examination for newborn under 8 days oldEncntr for general exam w/o complaint, susp or reprtd dx (Z00)
Z00.111Health examination for newborn 8 to 28 days oldEncntr for general exam w/o complaint, susp or reprtd dx (Z00)
Z05.0Observation and evaluation of newborn for suspected cardiac condition ruled outEnctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
Z05.1Observation and evaluation of newborn for suspected infectious condition ruled outEnctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
Z05.2Observation and evaluation of newborn for suspected neurological condition ruled outEnctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
Z05.3Observation and evaluation of newborn for suspected respiratory condition ruled outEnctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
Z05.41Observation and evaluation of newborn for suspected genetic condition ruled outEnctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
Z05.42Observation and evaluation of newborn for suspected metabolic condition ruled outEnctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
Z05.43Observation and evaluation of newborn for suspected immunologic condition ruled outEnctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
Z05.5Observation and evaluation of newborn for suspected gastrointestinal condition ruled outEnctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
Z05.6Observation and evaluation of newborn for suspected genitourinary condition ruled outEnctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
Z05.71Observation and evaluation of newborn for suspected skin and subcutaneous tissue condition ruled outEnctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
Z05.72Observation and evaluation of newborn for suspected musculoskeletal condition ruled outEnctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
Z05.73Observation and evaluation of newborn for suspected connective tissue condition ruled outEnctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
Z05.81Observation and evaluation of newborn for suspected condition related to home physiologic monitoring device ruled outEnctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
Z05.89Observation and evaluation of newborn for other specified suspected condition ruled outEnctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
Z05.9Observation and evaluation of newborn for unspecified suspected condition ruled outEnctr for Obs & eval of NB for susp diseases and cond R/O (Z05)
Z38.00Single liveborn infant, delivered vaginallyLiveborn infants according to place of birth and type of del (Z38)
Z38.01Single liveborn infant, delivered by cesareanLiveborn infants according to place of birth and type of del (Z38)
Z38.1Single liveborn infant, born outside hospitalLiveborn infants according to place of birth and type of del (Z38)
Z38.2Single liveborn infant, unspecified as to place of birthLiveborn infants according to place of birth and type of del (Z38)
Z38.30Twin liveborn infant, delivered vaginallyLiveborn infants according to place of birth and type of del (Z38)
Z38.31Twin liveborn infant, delivered by cesareanLiveborn infants according to place of birth and type of del (Z38)
Z38.4Twin liveborn infant, born outside hospitalLiveborn infants according to place of birth and type of del (Z38)
Z38.5Twin liveborn infant, unspecified as to place of birthLiveborn infants according to place of birth and type of del (Z38)
Z38.61Triplet liveborn infant, delivered vaginallyLiveborn infants according to place of birth and type of del (Z38)
Z38.62Triplet liveborn infant, delivered by cesareanLiveborn infants according to place of birth and type of del (Z38)
Z38.63Quadruplet liveborn infant, delivered vaginallyLiveborn infants according to place of birth and type of del (Z38)
Z38.64Quadruplet liveborn infant, delivered by cesareanLiveborn infants according to place of birth and type of del (Z38)
Z38.65Quintuplet liveborn infant, delivered vaginallyLiveborn infants according to place of birth and type of del (Z38)
Z38.66Quintuplet liveborn infant, delivered by cesareanLiveborn infants according to place of birth and type of del (Z38)
Z38.68Other multiple liveborn infant, delivered vaginallyLiveborn infants according to place of birth and type of del (Z38)
Z38.69Other multiple liveborn infant, delivered by cesareanLiveborn infants according to place of birth and type of del (Z38)
Z38.7Other multiple liveborn infant, born outside hospitalLiveborn infants according to place of birth and type of del (Z38)
Z38.8Other multiple liveborn infant, unspecified as to place of birthLiveborn infants according to place of birth and type of del (Z38)