# ICD-10 Chapter 16 Guidelines Question



## JillRBurnham (Jan 5, 2014)

Good Afternoon!  

I have a question about the ICD-10 chapter 16 guidelines, section d.  

The guidelines state "Codes from the category P05 should NOT be assigned with codes from category P07." 

Then 2 sentences later it states "A code from P05 and codes from P07.2 and P07.3 may be used to specify weeks of gestation as documented by the provider in the record."

This seems to be contradictory. 

Can someone explain this so I understand it better?

Thank you!!



Jill Burnham, CPC-A
Hartford, CT Chapter
860-597-4584
jill.r.burnham@gmail.com


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## mitchellde (Jan 5, 2014)

JillRBurnham said:


> Good Afternoon!
> 
> I have a question about the ICD-10 chapter 16 guidelines, section d.
> 
> ...



I think you may have read the guidelines incorrectly .  Here is a paste from the 2014 version of the guidelines :
Codes from category P05 should not be assigned with codes from category P07.
When both birth weight and gestational age are available, two codes from category P07 should be assigned, with the code for birth weight sequenced before the code for gestational age.


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## OCD_coder (Jan 5, 2014)

I too am trying to learn this chapter and this is only my personal view from my education I am receiving.  If someone has a different view/explanation I gladly want to read it.  

I have double checked my ICD-10 Draft with the CDC ICD-10 Guidelines (see link)  I am not interpreting it similar to Jill, if you read it and interpret it in the order it is written in the Book, vs on the CDC link.  The guidelines are not saying to use both the P05 and P07 together, but that those codes are similar as they relate to low birth weight in newborns.
Link:  http://www.cdc.gov/nchs/data/icd/icd10cm_guidelines_2014.pdf
ICD-10-CM Official Guidelines for Coding and Reporting
2014
Page 63 of 117

_A code for prematurity should not be assigned unless it is documented.  Assignment of codes in categories P05, Disorders of newborn related to slow fetal growth and fetal malnutrition, and P07, Disorders of newborn related to short gestation and low birth weight, not elsewhere classified, should be based on the recorded birth weight and estimated gestational age.  When both birth weight and gestational age are available, two codes from category P07 should be assigned, with the code for birth weight sequenced before the code for gestational age.  Codes from category P05 should not be assigned with codes from category P07. _ 

Our providers will need to document the specific cause of the low birth weight when known and the gestational age for us to select the best Dx code for the encounter.  I can't use two codes that relate to the birth weight sans the instructions not to use both  P05 with P07 codes.  When documented for premature newborns we will need to select a code 1st from P07.0 -     P07.1 and then one of the gestational P07.2-P07.3 codes.  P05 would potentially be for a full term newborn with low birth weight due to malnutrition.  While the P07 codes only relate to short gestation and low birth weight.

P05 Disorders of newborn *related to slow fetal growth and fetal malnutrition *
P05.0_    Newborn light for gestational age
P05.1_    Newborn small for gestational age
P05.2_    Newborn affected by fetal (intrauterine) malnutrition not light or small for gestational age
P05.9_    Newborn affected by slow intrauterine growth, unspecified
P07 Disorders of newborn *related to short gestation and low birth weight*, not elsewhere classified
Note: When both birth weight and gestational age of the newborn are available, both should be coded with birth weight sequenced before gestational age

Type 1 Excludes  low birth weight due to slow fetal growth and fetal malnutrition (P05.-)

Includes the listed conditions, without further specification, as the cause of morbidity or additional care, in newborn (documentation should specify preterm/premie)
P07.0_    Extremely low birth weight newborn
P07.1_   Other low birth weight newborn
P07.2_    *Extreme immaturity of newborn (<27 weeks)*
P07.3_    *Preterm [premature] newborn (28-36 weeks)[other]*


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## JillRBurnham (Jan 5, 2014)

Thank you very much for your reply.  I am using the 2013 draft, so the wording may have changed. 

This helped clarify the question I posed.  

I sincerely appreciate your assistance!

~ Jill R. Burnham, CPC-A


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## lorrpb (Jan 5, 2014)

The OGCR in the 2014 physical manual (AAPC) which is titled as 2014 OGCR is different from the 2014 OGCR electronic file downloaded from CMS. The electronic file does NOT contain the sentence "A code from P05 and codes from P07.2 and P07.3 may be used to specify weeks of gestation as documented by the provider in the record." This sentence DOES appear in the physical manual, even though it is labelled as 2014 OGCR. In the electronic file, it is NOT marked as a deletion, which it should be.


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