Pediatric diagnoses - ICD-10-CM Medicare Code Edits
The Medicare Code Editor detects inconsistencies in pediatric cases by checking a patient's age and any diagnosis on the patient's record. The pediatric code edits apply to patients age range is 0–17 years inclusive (e.g., Reye's syndrome, routine child health exam).
The following 122 ICD-10-CM codes are intended for pediatric diagnoses
| ICD Code | Description | Category |
|---|---|---|
| A48.51 | Infant botulism | Other bacterial diseases, not elsewhere classified (A48) |
| B08.20 | Exanthema subitum [sixth disease], unspecified | Oth viral infect with skin and mucous membrane lesions, NEC (B08) |
| B08.21 | Exanthema subitum [sixth disease] due to human herpesvirus 6 | Oth viral infect with skin and mucous membrane lesions, NEC (B08) |
| B08.22 | Exanthema subitum [sixth disease] due to human herpesvirus 7 | Oth viral infect with skin and mucous membrane lesions, NEC (B08) |
| C93.30 | Juvenile myelomonocytic leukemia, not having achieved remission | Monocytic leukemia (C93) |
| C93.31 | Juvenile myelomonocytic leukemia, in remission | Monocytic leukemia (C93) |
| C93.32 | Juvenile myelomonocytic leukemia, in relapse | Monocytic leukemia (C93) |
| E30.1 | Precocious puberty | Disorders of puberty, not elsewhere classified (E30) |
| E30.8 | Other disorders of puberty | Disorders of puberty, not elsewhere classified (E30) |
| F64.2 | Gender identity disorder of childhood | Gender identity disorders (F64) |
| F84.3 | Other childhood disintegrative disorder | Pervasive developmental disorders (F84) |
| G93.7 | Reye's syndrome | Other disorders of brain (G93) |
| H26.001 | Unspecified infantile and juvenile cataract, right eye | Other cataract (H26) |
| H26.002 | Unspecified infantile and juvenile cataract, left eye | Other cataract (H26) |
| H26.003 | Unspecified infantile and juvenile cataract, bilateral | Other cataract (H26) |
| H26.009 | Unspecified infantile and juvenile cataract, unspecified eye | Other cataract (H26) |
| H26.011 | Infantile and juvenile cortical, lamellar, or zonular cataract, right eye | Other cataract (H26) |
| H26.012 | Infantile and juvenile cortical, lamellar, or zonular cataract, left eye | Other cataract (H26) |
| H26.013 | Infantile and juvenile cortical, lamellar, or zonular cataract, bilateral | Other cataract (H26) |
| H26.019 | Infantile and juvenile cortical, lamellar, or zonular cataract, unspecified eye | Other cataract (H26) |
| H26.031 | Infantile and juvenile nuclear cataract, right eye | Other cataract (H26) |
| H26.032 | Infantile and juvenile nuclear cataract, left eye | Other cataract (H26) |
| H26.033 | Infantile and juvenile nuclear cataract, bilateral | Other cataract (H26) |
| H26.039 | Infantile and juvenile nuclear cataract, unspecified eye | Other cataract (H26) |
| H26.041 | Anterior subcapsular polar infantile and juvenile cataract, right eye | Other cataract (H26) |
| H26.042 | Anterior subcapsular polar infantile and juvenile cataract, left eye | Other cataract (H26) |
| H26.043 | Anterior subcapsular polar infantile and juvenile cataract, bilateral | Other cataract (H26) |
| H26.049 | Anterior subcapsular polar infantile and juvenile cataract, unspecified eye | Other cataract (H26) |
| H26.051 | Posterior subcapsular polar infantile and juvenile cataract, right eye | Other cataract (H26) |
| H26.052 | Posterior subcapsular polar infantile and juvenile cataract, left eye | Other cataract (H26) |
| H26.053 | Posterior subcapsular polar infantile and juvenile cataract, bilateral | Other cataract (H26) |
| H26.059 | Posterior subcapsular polar infantile and juvenile cataract, unspecified eye | Other cataract (H26) |
| H26.061 | Combined forms of infantile and juvenile cataract, right eye | Other cataract (H26) |
| H26.062 | Combined forms of infantile and juvenile cataract, left eye | Other cataract (H26) |
| H26.063 | Combined forms of infantile and juvenile cataract, bilateral | Other cataract (H26) |
| H26.069 | Combined forms of infantile and juvenile cataract, unspecified eye | Other cataract (H26) |
| H26.09 | Other infantile and juvenile cataract | Other cataract (H26) |
| L12.2 | Chronic bullous disease of childhood | Pemphigoid (L12) |
| L20.83 | Infantile (acute) (chronic) eczema | Atopic dermatitis (L20) |
| L21.1 | Seborrheic infantile dermatitis | Seborrheic dermatitis (L21) |
| L44.4 | Infantile papular acrodermatitis [Gianotti-Crosti] | Other papulosquamous disorders (L44) |
| L70.4 | Infantile acne | Acne (L70) |
| N92.2 | Excessive menstruation at puberty | Excessive, frequent and irregular menstruation (N92) |
| R04.81 | Acute idiopathic pulmonary hemorrhage in infants | Hemorrhage from respiratory passages (R04) |
| R10.83 | Colic | Abdominal and pelvic pain (R10) |
| R62.0 | Delayed milestone in childhood | Lack of expected normal physiol dev in childhood and adults (R62) |
| R62.51 | Failure to thrive (child) | Lack of expected normal physiol dev in childhood and adults (R62) |
| R63.31 | Pediatric feeding disorder, acute | Symptoms and signs concerning food and fluid intake (R63) |
| R63.32 | Pediatric feeding disorder, chronic | Symptoms and signs concerning food and fluid intake (R63) |
| R68.11 | Excessive crying of infant (baby) | Other general symptoms and signs (R68) |
| R68.12 | Fussy infant (baby) | Other general symptoms and signs (R68) |
| R68.13 | Apparent life threatening event in infant (ALTE) | Other general symptoms and signs (R68) |
| R68.19 | Other nonspecific symptoms peculiar to infancy | Other general symptoms and signs (R68) |
| T74.02XA | Child neglect or abandonment, confirmed, initial encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.02XD | Child neglect or abandonment, confirmed, subsequent encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.02XS | Child neglect or abandonment, confirmed, sequela | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.12XA | Child physical abuse, confirmed, initial encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.12XD | Child physical abuse, confirmed, subsequent encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.12XS | Child physical abuse, confirmed, sequela | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.22XA | Child sexual abuse, confirmed, initial encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.22XD | Child sexual abuse, confirmed, subsequent encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.22XS | Child sexual abuse, confirmed, sequela | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.32XA | Child psychological abuse, confirmed, initial encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.32XD | Child psychological abuse, confirmed, subsequent encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.32XS | Child psychological abuse, confirmed, sequela | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.4XXA | Shaken infant syndrome, initial encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.4XXD | Shaken infant syndrome, subsequent encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.4XXS | Shaken infant syndrome, sequela | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.52XA | Child sexual exploitation, confirmed, initial encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.52XD | Child sexual exploitation, confirmed, subsequent encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.52XS | Child sexual exploitation, confirmed, sequela | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.62XA | Child forced labor exploitation, confirmed, initial encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.62XD | Child forced labor exploitation, confirmed, subsequent encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.62XS | Child forced labor exploitation, confirmed, sequela | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.92XA | Unspecified child maltreatment, confirmed, initial encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.92XD | Unspecified child maltreatment, confirmed, subsequent encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.92XS | Unspecified child maltreatment, confirmed, sequela | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.A2XA | Child financial abuse, confirmed, initial encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.A2XD | Child financial abuse, confirmed, subsequent encounter | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T74.A2XS | Child financial abuse, confirmed, sequela | Adult and child abuse, neglect and oth maltreat, confirmed (T74) |
| T76.02XA | Child neglect or abandonment, suspected, initial encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.02XD | Child neglect or abandonment, suspected, subsequent encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.02XS | Child neglect or abandonment, suspected, sequela | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.12XA | Child physical abuse, suspected, initial encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.12XD | Child physical abuse, suspected, subsequent encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.12XS | Child physical abuse, suspected, sequela | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.22XA | Child sexual abuse, suspected, initial encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.22XD | Child sexual abuse, suspected, subsequent encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.22XS | Child sexual abuse, suspected, sequela | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.32XA | Child psychological abuse, suspected, initial encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.32XD | Child psychological abuse, suspected, subsequent encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.32XS | Child psychological abuse, suspected, sequela | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.52XA | Child sexual exploitation, suspected, initial encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.52XD | Child sexual exploitation, suspected, subsequent encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.52XS | Child sexual exploitation, suspected, sequela | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.62XA | Child forced labor exploitation, suspected, initial encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.62XD | Child forced labor exploitation, suspected, subsequent encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.62XS | Child forced labor exploitation, suspected, sequela | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.92XA | Unspecified child maltreatment, suspected, initial encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.92XD | Unspecified child maltreatment, suspected, subsequent encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.92XS | Unspecified child maltreatment, suspected, sequela | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.A2XA | Child financial abuse, suspected, initial encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.A2XD | Child financial abuse, suspected, subsequent encounter | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| T76.A2XS | Child financial abuse, suspected, sequela | Adult and child abuse, neglect and oth maltreat, suspected (T76) |
| Z00.121 | Encounter for routine child health examination with abnormal findings | Encntr for general exam w/o complaint, susp or reprtd dx (Z00) |
| Z00.129 | Encounter for routine child health examination without abnormal findings | Encntr for general exam w/o complaint, susp or reprtd dx (Z00) |
| Z00.2 | Encounter for examination for period of rapid growth in childhood | Encntr for general exam w/o complaint, susp or reprtd dx (Z00) |
| Z00.3 | Encounter for examination for adolescent development state | Encntr for general exam w/o complaint, susp or reprtd dx (Z00) |
| Z00.70 | Encounter for examination for period of delayed growth in childhood without abnormal findings | Encntr for general exam w/o complaint, susp or reprtd dx (Z00) |
| Z00.71 | Encounter for examination for period of delayed growth in childhood with abnormal findings | Encntr for general exam w/o complaint, susp or reprtd dx (Z00) |
| Z04.42 | Encounter for examination and observation following alleged child rape | Encounter for examination and observation for other reasons (Z04) |
| Z04.72 | Encounter for examination and observation following alleged child physical abuse | Encounter for examination and observation for other reasons (Z04) |
| Z62.21 | Child in welfare custody | Problems related to upbringing (Z62) |
| Z62.3 | Hostility towards and scapegoating of child | Problems related to upbringing (Z62) |
| Z69.010 | Encounter for mental health services for victim of parental child abuse | Encntr for mental health serv for victim and perp of abuse (Z69) |
| Z69.020 | Encounter for mental health services for victim of non-parental child abuse | Encntr for mental health serv for victim and perp of abuse (Z69) |
| Z72.810 | Child and adolescent antisocial behavior | Problems related to lifestyle (Z72) |
| Z73.810 | Behavioral insomnia of childhood, sleep-onset association type | Problems related to life management difficulty (Z73) |
| Z73.811 | Behavioral insomnia of childhood, limit setting type | Problems related to life management difficulty (Z73) |
| Z73.812 | Behavioral insomnia of childhood, combined type | Problems related to life management difficulty (Z73) |
| Z73.819 | Behavioral insomnia of childhood, unspecified type | Problems related to life management difficulty (Z73) |
| Z76.2 | Encounter for health supervision and care of other healthy infant and child | Persons encountering health services in other circumstances (Z76) |