Cracking the Code

Coding in the Perinatal Period

According to the FY 2023 ICD-10-CM Guidelines, for coding and reporting purposes the perinatal period is defined as before birth through the 28th day following birth. Codes in this chapter are never for use on the maternal record. The guidelines are very clear that Chapter 15 codes are never permitted on the newborn record. The codes in Chapter 16 may be used throughout the life of the patient if the condition is still present. A general rule of thumb while coding in the perinatal period is all clinically significant conditions noted on routine newborn exams should be coded. A condition is clinically significant if it requires clinical evaluation, therapeutic treatment, diagnostic procedures, extended length of hospital stay, increased nursing care and monitoring, or has implications for future healthcare needs. It should also be noted that if a condition is documented at birth that can be either community-acquired or due to the birth process, and the documentation does not specify, the condition is reported as due to the birth process as the default.

Q: A 23-day-old infant develops bradycardia. What ICD-10-CM code is reported?
A: P29.12 Rationale: In our ICD-10-CM book, the guideline I.C.16 is defined as ‘before birth through the 28th day following birth.’ In the ICD-10-CM Alphabetic Index, we look for Bradycardia/neonatal, guiding us to code P29.12. As always, we want to ensure we verify this code selection in the Tabular List.
Reference: FY 2023 ICD-10-CM Coding Guidelines
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