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v1.0.0
ICD-10 Guide
ICD-10 CodesP01.0

P01.0

Billable

Newborn affected by incompetent cervix

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 P01.0 is a billable code used to indicate a diagnosis of newborn affected by incompetent cervix.

Key Diagnostic Point:

Incompetent cervix, also known as cervical insufficiency, is a condition where the cervix begins to dilate and efface prematurely, often leading to preterm birth. In the context of newborns, this condition is significant as it can result in various complications, including low birth weight, respiratory distress syndrome, and increased risk of neonatal morbidity. Newborns affected by an incompetent cervix may present with signs of prematurity, such as difficulty maintaining body temperature, feeding challenges, and potential neurological issues. The condition is often associated with maternal complications during pregnancy, such as premature rupture of membranes and multiple pregnancies, which can further complicate the clinical picture. Accurate coding for this condition is essential for appropriate management and resource allocation in neonatal care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between causes of prematurity
  • Documenting maternal history accurately
  • Identifying associated complications
  • Understanding the implications of multiple gestations

Audit Risk Factors

  • Inadequate documentation of maternal history
  • Failure to link maternal complications to newborn outcomes
  • Misclassification of prematurity causes
  • Omission of associated conditions in coding

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of gestational age, birth weight, and any complications observed in the NICU.

Common Clinical Scenarios

Newborns presenting with respiratory distress, feeding intolerance, or temperature instability due to prematurity.

Billing Considerations

Ensure accurate coding of any additional complications such as respiratory distress syndrome or intraventricular hemorrhage.

Pediatrics

Documentation Requirements

Comprehensive pediatric assessments that include developmental milestones and follow-up care for prematurity-related issues.

Common Clinical Scenarios

Pediatric visits for growth monitoring and developmental assessments in infants born preterm due to incompetent cervix.

Billing Considerations

Consider the long-term implications of prematurity on health outcomes and ensure continuity of care documentation.

Coding Guidelines

Inclusion Criteria

Use P01.0 When
  • Follow the ICD
  • CM Official Guidelines for Coding and Reporting, ensuring that all relevant maternal complications are documented and linked to the newborn's condition
  • Utilize additional codes for any associated conditions as necessary

Exclusion Criteria

Do NOT use P01.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99460CPT Code

Initial hospital care, per day, for evaluation and management of a normal newborn

Clinical Scenario

Used when a newborn affected by incompetent cervix requires initial evaluation in the NICU.

Documentation Requirements

Document the newborn's clinical status, gestational age, and any interventions performed.

Specialty Considerations

Neonatologists should ensure that all relevant complications are documented to support the coding.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, improving the ability to capture the complexities of cases like P01.0. This specificity aids in better resource allocation and management of neonatal care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, improving the ability to capture the complexities of cases like P01.0. This specificity aids in better resource allocation and management of neonatal care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, improving the ability to capture the complexities of cases like P01.0. This specificity aids in better resource allocation and management of neonatal care.

Resources

Clinical References

  • •
    ICD-10-CM Coding Guidelines

Coding & Billing References

  • •
    ICD-10-CM Coding Guidelines

Frequently Asked Questions

What documentation is required for coding P01.0?

Documentation should include maternal history of incompetent cervix, gestational age at birth, any complications observed in the newborn, and details of the clinical management provided.