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v1.0.0
ICD-10 Guide
ICD-10 CodesP01.4

P01.4

Billable

Newborn affected by ectopic pregnancy

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

Code Description

ICD-10 P01.4 is a billable code used to indicate a diagnosis of newborn affected by ectopic pregnancy.

Key Diagnostic Point:

Newborns affected by ectopic pregnancy are those who experience complications due to the mother's ectopic gestation. Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, often in the fallopian tube. This condition can lead to maternal complications such as hemorrhage, infection, and the need for surgical intervention, which may affect the newborn's health. Newborns may present with low birth weight, prematurity, or other complications related to maternal health issues. The impact on the newborn can vary based on the timing of the ectopic pregnancy diagnosis and the interventions performed. Maternal conditions such as incompetent cervix, premature rupture of membranes, or multiple pregnancies can further complicate the situation, leading to increased risks for the newborn. Proper documentation and coding are essential to capture the nuances of these cases accurately.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in maternal complications affecting newborn outcomes
  • Need for detailed maternal history to understand the impact on the newborn
  • Potential for multiple diagnoses related to maternal and neonatal conditions
  • Documentation of interventions and their effects on the newborn's health

Audit Risk Factors

  • Inadequate documentation of maternal health history
  • Failure to link maternal complications to newborn outcomes
  • Misclassification of the type of ectopic pregnancy
  • Omission of relevant neonatal assessments

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of neonatal assessments, including weight, gestational age, and any complications observed.

Common Clinical Scenarios

Newborns admitted to the NICU for respiratory distress or low birth weight due to maternal complications.

Billing Considerations

Attention to maternal history and interventions that may affect neonatal care and outcomes.

Pediatrics

Documentation Requirements

Comprehensive pediatric evaluations that include developmental assessments and follow-up care plans.

Common Clinical Scenarios

Pediatric visits for newborns with ongoing issues stemming from maternal complications.

Billing Considerations

Consideration of long-term effects on growth and development due to initial complications.

Coding Guidelines

Inclusion Criteria

Use P01.4 When
  • Follow official ICD
  • 10 guidelines for perinatal coding, ensuring accurate documentation of maternal conditions and their direct effects on the newborn
  • Use additional codes as necessary to capture associated complications

Exclusion Criteria

Do NOT use P01.4 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 for newborns requiring evaluation due to maternal complications.

Documentation Requirements

Document the newborn's condition and any interventions performed.

Specialty Considerations

Neonatologists should ensure thorough documentation of maternal history.

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 nuances of cases like P01.4. This specificity aids in better understanding 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 nuances of cases like P01.4. This specificity aids in better understanding 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 nuances of cases like P01.4. This specificity aids in better understanding and management of neonatal care.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the key considerations when coding for newborns affected by ectopic pregnancy?

Key considerations include thorough documentation of maternal health history, understanding the implications of maternal complications on the newborn, and ensuring accurate linkage between maternal and neonatal diagnoses.