Wiki Observation For Newborn Conditions Ruled Out After 28 Days

[Meghanmier]

Hello fellow coders. I am a fairly new radiology coder, and I get a lot of charts for babies/infants being observed for hip dysplasia (and sometimes other things) that is subsequently ruled out. I code in Epic, and it doesn't like me to use the newborn observation ICD-10-CM code for infants >28 days, even if they're only a couple months old (e.g. Z05.72, observation and evaluation of newborn for suspected MS condition ruled out). So my question is, assuming there aren't any diagnostic findings, would I just use the general code for conditions ruled-out (Z03.89, encounter for observation for other suspected diseases and conditions ruled out)? Most of the babies were also born breech, so would I just use that code if they are past 28 days and there are no significant findings? I have scoured the guidelines but I can't find anything specifying what code to use after the 28 days, but maybe I missed it. Thank you!

 

[Cynthia Hughes]

I am not sure whether Epic will allow this but it would be correct to report Z03.89 and P03.0 (Newborn (suspected to be) affected by breech delivery and extraction) when the infant was born breech. Despite some coding edits, P codes are not limited to the infant's neonatal period but rather to conditions that originate in the infant's neonatal period. For any infant who has findings like a hip click (R29.4), the symptom code makes this a lot easier. Cindy

 

[Meghanmier]

Okay, cool, that is what I have been doing in that case. Thank you!