Cracking the Code

Newborn Patient Admitted to Observation with Ruled-Out Condition

Sometimes, newborns are admitted for observation and evaluation of suspected conditions. Per ICD-10-CM Official Guidelines for Coding and Reporting FY 2021, it is appropriate to report a diagnosis code from category Z05, observation and evaluation of newborns and infants for suspected conditions ruled out. A code from this category identifies when a healthy newborn is evaluated for a suspected condition that is determined to not be present after the provider completes a full study of the newborn. Z05 should ONLY be reported if the newborn does not have any signs and symptoms. If the newborn has confirmed signs and symptoms of a suspected problem, then it is appropriate to report the signs and symptoms instead. Lastly, when Z05 is reported on a birth record, it is important to sequence the diagnoses correctly. A diagnosis from category Z38, liveborn infants should be reported as the primary diagnosis followed by a code from category Z05 as a secondary diagnosis.

Reference: References: ICD-10-CM Official Guidelines for Coding and Reporting FY 2021 Section I.C.16.b.
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