Primary Care Coding Alert

Question: An 8-day-old presents with trouble nursing. The mother explains the baby eats slowly and briefly then vomits white liquid shortly after being burped. Bowel movements are normal, and the primary care practitioner (PCP) determines there are no GI problems. Do I code these with R63.3- or F50.-?

California Subscriber

Answer: You won’t report either code, because both R63.3- (Feeding difficulties) and F50.- (Eating disorders) groups are designated for patients over 28 days old.

For neonates, you’ll turn to the P92 (Feeding problems of newborn) block. In this case, multiple codes may be applicable. For instance, breastfeeding is a concern, which would code to P92.5 (Neonatal difficulty in feeding at breast). Which additional code(s) you report will depend on the details the provider included in the documentation. The mother’s report of the baby eating slowly may implicate code P92.2 (Slow feeding of newborn). To report the vomiting, turn to P92.1 (Regurgitation and rumination of newborn).

Note: P92.1 is a better choice over P92.01 (Bilious vomiting of newborn) for this encounter as the child’s vomit is a whitish color, indicating regurgitation of whitish-colored milk rather than a yellowish green color indicating the presence of bile. On a similar note, P92.09 (Other vomiting of newborn) is technically accurate, but much less specific than P92.1 and, therefore, not the preferred choice.