# ICD-10 Perinatal condition coding



## shruthi (Jul 5, 2013)

Chapter specific coding guidelines for Chapter 16 (Certain conditions originating in the Perinatal period P00-P96) states as below,

*Use of Chapter 16 codes after the perinatal period:
Should a condition originate in the perinatal period and continue throughtout the life of the patient, the perinatal code should continue to be used regardless of the patients age.*

As per the above guidelines, Chapter 16 codes can be used throught out the age of the patient if the perinatal condition is still present. But Chapter 16 is confined to only perinatal period which commences from date of delivery till 28 days. So how can we still use the chapter 16 codes to older patients? Will we not end up in rejections and denials?

Thoughts.

Regards,
Shruthi


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## pamtienter (Jul 9, 2013)

Per the notes at the beginning of Chapter 16, these codes are for conditions that have their origin in the fetal or perinatal period (before birth through the first 28 days after birth) even if morbidity occurs later. This means there isn't an age restriction for the patient if they have a condition in this chapter that originated within the first 28 days of their life.


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## shruthi (Jul 11, 2013)

I agree with your point. But my concern was, in the ICD-10 book we have the symbol '*N*' for all chapter 16 codes, which means we should bill chapter 16 codes only to neonates. So how can we assign chapter 16 codes to older patients?
As these codes are for conditions that have their origin in the fetal or perinatal period (before birth through the first 28 days after birth) and if morbidity occurs later, then how can we code for such patients?

Regards,
Shruthi


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## Kisalyn (Jul 11, 2013)

We have the 2012 ICD-10 Draft book by Contexto. We ordered early just to see how the codes were laid out and I see now that the age symbols are missing.

With ICD-9, when I was looking at this portion of the guidelines, an example that helped me understand was assigning 770.7 to an adult. The condition originated in the perinatal period, but is assigned if it remains in adulthood.

Do you see an "N" for neonate on the code *P27.1 *(bronchopulomary dysplasia originating in the perinatal period) in your ICD-10 book?

If every single code is only allowed on neonates, then I can see your confusion.


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## smithj7 (Jul 23, 2013)

shruthi - the guidelines for Chapter 16 in the front of the book under A and 4 (under A) states:

Use of Chapter 16 codes after the perinatal period:
Should a condition originate in the perinatal period, and continue throughout the life of the patient, the perinatal code should continue to be used regardless of the patient's age.

So the N on nearly all the codes is not truly age restrictive based on the above guideline.

Smithj7


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## mitchellde (Jul 23, 2013)

shruthi said:


> I agree with your point. But my concern was, in the ICD-10 book we have the symbol '*N*' for all chapter 16 codes, which means we should bill chapter 16 codes only to neonates. So how can we assign chapter 16 codes to older patients?
> As these codes are for conditions that have their origin in the fetal or perinatal period (before birth through the first 28 days after birth) and if morbidity occurs later, then how can we code for such patients?
> 
> Regards,
> Shruthi



Which version of the ICD-10 do you have?  Because mine does not have the N symbol for any of the codes nor does any of the books I have looked at have this.


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## smithj7 (Jul 25, 2013)

Deb, 

The Optum/Ingenix 2013 draft ICD-10 CM book has the 'N' on all the codes in chapter 16 except the P27 series.  

Smithj7


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## Cynthia Hughes (Aug 9, 2013)

I believe that the age indicators that are included in some ICD books are based on the Medicare Code Editor and not the ICD-9-CM or ICD-10-CM guidelines and conventions. Chapter 16 codes may be used throughout the life of the patient if the condition is still present. The emphasis of the previous sentence would be "the condition is still present" and not that it was present during the perinatal period.


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