Pediatric Coding Alert

Question: Our pediatrician documented that a neonate had jaundice; the baby had been born preterm at 36 weeks. Which code should I use to document this: P59.0 or P59.9?

Ohio Subscriber

Answer: ICD-10 codes for neonatal jaundice are divided into codes that specify the cause for the jaundice, which carry the words “due to” or “from” in the code descriptors. Like the term “with,” these terms are relational, meaning that the conditions “should be coded as related even in the absence of provider documentation explicitly linking them, unless the documentation clearly states the conditions are unrelated….” Conversely, “for conditions not specifically linked by these relational terms … provider documentation must link the conditions in order to code them as related” (see, for example, ICD-10 guideline A.15).

In your example, even though neonatal jaundice can be attributed to the patient’s premature birth, the jaundice can also be attributed to a number of other factors. Because of this, you will need to find provider documentation in the patient’s notes that confirms the direct cause of the patient’s hyperbilirubinemia was the patient’s prematurity before you assign P59.0 (Neonatal jaundice associated with preterm delivery). Otherwise, if the pediatrician simply documents “neonatal jaundice,” P59.9 (Neonatal jaundice, unspecified) is the correct diagnosis code to use.