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v1.0.0
ICD-10 Guide
ICD-10 CodesP02.6

P02.6

Billable

Newborn affected by other and unspecified conditions of umbilical cord

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

Code Description

ICD-10 P02.6 is a billable code used to indicate a diagnosis of newborn affected by other and unspecified conditions of umbilical cord.

Key Diagnostic Point:

P02.6 refers to newborns who are affected by various complications associated with the umbilical cord, which may include conditions such as placenta previa, cord prolapse, and chorioamnionitis. These conditions can lead to significant perinatal morbidity and mortality. For instance, placenta previa occurs when the placenta is abnormally positioned over the cervix, potentially causing bleeding during delivery and affecting fetal oxygenation. Cord prolapse happens when the umbilical cord slips ahead of the presenting part of the fetus, which can compress the cord and compromise blood flow. Chorioamnionitis, an infection of the fetal membranes, can lead to premature rupture of membranes and subsequent complications for the newborn, including sepsis. Accurate coding of these conditions is crucial for appropriate management and resource allocation in neonatal care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation of umbilical cord conditions
  • Need for detailed documentation of maternal and fetal history
  • Differentiation between similar conditions (e.g., cord prolapse vs. cord accidents)
  • Potential for multiple coding scenarios based on maternal conditions

Audit Risk Factors

  • Inadequate documentation of maternal conditions leading to umbilical cord issues
  • Misclassification of conditions due to overlapping symptoms
  • Failure to capture all relevant complications in coding
  • Inconsistent use of terminology in clinical notes

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed neonatal assessments, including Apgar scores, vital signs, and any interventions performed.

Common Clinical Scenarios

Newborns presenting with respiratory distress due to cord complications, or requiring NICU admission for monitoring.

Billing Considerations

Coders must ensure that all relevant neonatal complications are documented to support the use of P02.6.

Pediatrics

Documentation Requirements

Comprehensive pediatric evaluations that include follow-up assessments of newborns affected by umbilical cord conditions.

Common Clinical Scenarios

Pediatric visits for newborns with a history of chorioamnionitis or other umbilical cord-related complications.

Billing Considerations

Pediatric coders should be aware of the long-term implications of umbilical cord conditions on child development.

Coding Guidelines

Inclusion Criteria

Use P02.6 When
  • Coders should refer to the official ICD
  • CM guidelines for perinatal coding, ensuring that all relevant maternal and neonatal conditions are documented and coded appropriately

Exclusion Criteria

Do NOT use P02.6 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 affected by umbilical cord conditions requiring initial assessment.

Documentation Requirements

Documentation of the newborn's condition, including any complications observed.

Specialty Considerations

Neonatologists should ensure that all relevant clinical findings are documented to support billing.

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 accuracy of diagnoses and facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, improving the accuracy of diagnoses and facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, improving the accuracy of diagnoses and facilitating better patient management.

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 common complications associated with umbilical cord conditions?

Common complications include fetal distress, hypoxia, and increased risk of infection, which can lead to significant morbidity in newborns.