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 41 ICD-10-CM codes are intended for perinatal / newborn diagnoses
| ICD Code | Description | Category |
|---|---|---|
| A33 | Tetanus neonatorum | Tetanus neonatorum (A33) |
| E84.11 | Meconium ileus in cystic fibrosis | Cystic fibrosis (E84) |
| H04.531 | Neonatal obstruction of right nasolacrimal duct | Disorders of lacrimal system (H04) |
| H04.532 | Neonatal obstruction of left nasolacrimal duct | Disorders of lacrimal system (H04) |
| H04.533 | Neonatal obstruction of bilateral nasolacrimal duct | Disorders of lacrimal system (H04) |
| H04.539 | Neonatal obstruction of unspecified nasolacrimal duct | Disorders of lacrimal system (H04) |
| N47.0 | Adherent prepuce, newborn | Disorders of prepuce (N47) |
| Z00.110 | Health examination for newborn under 8 days old | Encntr for general exam w/o complaint, susp or reprtd dx (Z00) |
| Z00.111 | Health examination for newborn 8 to 28 days old | Encntr for general exam w/o complaint, susp or reprtd dx (Z00) |
| Z05.0 | Observation and evaluation of newborn for suspected cardiac condition ruled out | Enctr for Obs & eval of NB for susp diseases and cond R/O (Z05) |
| Z05.1 | Observation and evaluation of newborn for suspected infectious condition ruled out | Enctr for Obs & eval of NB for susp diseases and cond R/O (Z05) |
| Z05.2 | Observation and evaluation of newborn for suspected neurological condition ruled out | Enctr for Obs & eval of NB for susp diseases and cond R/O (Z05) |
| Z05.3 | Observation and evaluation of newborn for suspected respiratory condition ruled out | Enctr for Obs & eval of NB for susp diseases and cond R/O (Z05) |
| Z05.41 | Observation and evaluation of newborn for suspected genetic condition ruled out | Enctr for Obs & eval of NB for susp diseases and cond R/O (Z05) |
| Z05.42 | Observation and evaluation of newborn for suspected metabolic condition ruled out | Enctr for Obs & eval of NB for susp diseases and cond R/O (Z05) |
| Z05.43 | Observation and evaluation of newborn for suspected immunologic condition ruled out | Enctr for Obs & eval of NB for susp diseases and cond R/O (Z05) |
| Z05.5 | Observation and evaluation of newborn for suspected gastrointestinal condition ruled out | Enctr for Obs & eval of NB for susp diseases and cond R/O (Z05) |
| Z05.6 | Observation and evaluation of newborn for suspected genitourinary condition ruled out | Enctr for Obs & eval of NB for susp diseases and cond R/O (Z05) |
| Z05.71 | Observation and evaluation of newborn for suspected skin and subcutaneous tissue condition ruled out | Enctr for Obs & eval of NB for susp diseases and cond R/O (Z05) |
| Z05.72 | Observation and evaluation of newborn for suspected musculoskeletal condition ruled out | Enctr for Obs & eval of NB for susp diseases and cond R/O (Z05) |
| Z05.73 | Observation and evaluation of newborn for suspected connective tissue condition ruled out | Enctr for Obs & eval of NB for susp diseases and cond R/O (Z05) |
| Z05.8 | Observation and evaluation of newborn for other specified suspected condition ruled out | Enctr for Obs & eval of NB for susp diseases and cond R/O (Z05) |
| Z05.9 | Observation and evaluation of newborn for unspecified suspected condition ruled out | Enctr for Obs & eval of NB for susp diseases and cond R/O (Z05) |
| Z38.00 | Single liveborn infant, delivered vaginally | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.01 | Single liveborn infant, delivered by cesarean | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.1 | Single liveborn infant, born outside hospital | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.2 | Single liveborn infant, unspecified as to place of birth | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.30 | Twin liveborn infant, delivered vaginally | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.31 | Twin liveborn infant, delivered by cesarean | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.4 | Twin liveborn infant, born outside hospital | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.5 | Twin liveborn infant, unspecified as to place of birth | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.61 | Triplet liveborn infant, delivered vaginally | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.62 | Triplet liveborn infant, delivered by cesarean | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.63 | Quadruplet liveborn infant, delivered vaginally | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.64 | Quadruplet liveborn infant, delivered by cesarean | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.65 | Quintuplet liveborn infant, delivered vaginally | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.66 | Quintuplet liveborn infant, delivered by cesarean | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.68 | Other multiple liveborn infant, delivered vaginally | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.69 | Other multiple liveborn infant, delivered by cesarean | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.7 | Other multiple liveborn infant, born outside hospital | Liveborn infants according to place of birth and type of del (Z38) |
| Z38.8 | Other multiple liveborn infant, unspecified as to place of birth | Liveborn infants according to place of birth and type of del (Z38) |
