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ICD-10 Guide
ICD-10 CodesP03.810

P03.810

Billable

Newborn affected by abnormality in fetal (intrauterine) heart rate or rhythm before the onset of labor

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

Code Description

ICD-10 P03.810 is a billable code used to indicate a diagnosis of newborn affected by abnormality in fetal (intrauterine) heart rate or rhythm before the onset of labor.

Key Diagnostic Point:

This code is used for newborns who exhibit abnormalities in fetal heart rate or rhythm prior to labor. Such abnormalities can arise from various factors, including maternal health conditions, placental issues, or fetal distress. These conditions may lead to complications during delivery, such as the need for cesarean section, forceps delivery, or breech delivery. The clinical implications of these heart rate irregularities can be significant, as they may indicate underlying fetal distress or compromise, necessitating close monitoring and potential interventions. Accurate coding is essential to reflect the complexity of care provided to these newborns, as they may require specialized neonatal care in the NICU or other settings to address any resultant complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fetal heart rate patterns and their clinical significance
  • Differentiation between types of delivery complications (e.g., breech, forceps, cesarean)
  • Need for detailed documentation of maternal and fetal health history
  • Potential for co-existing conditions that may complicate coding

Audit Risk Factors

  • Inadequate documentation of fetal heart rate monitoring
  • Failure to specify the type of delivery and its complications
  • Misclassification of the timing of heart rate abnormalities
  • Lack of clarity in maternal health history

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of fetal heart rate patterns, maternal health conditions, and delivery complications are essential.

Common Clinical Scenarios

Newborns requiring NICU admission due to fetal heart rate abnormalities, especially following complicated deliveries.

Billing Considerations

Neonatologists must be aware of the potential for long-term effects of fetal distress on neonatal outcomes.

Pediatrics

Documentation Requirements

Pediatricians should document any ongoing effects of fetal heart rate abnormalities on the newborn's health.

Common Clinical Scenarios

Follow-up care for newborns with a history of fetal heart rate abnormalities, assessing developmental milestones.

Billing Considerations

Consideration of the potential for developmental delays or other complications stemming from perinatal issues.

Coding Guidelines

Inclusion Criteria

Use P03.810 When
  • Perinatal coding guidelines emphasize the importance of accurately capturing the timing and nature of fetal heart rate abnormalities
  • Coders should ensure that documentation supports the diagnosis and reflects the complexity of care provided

Exclusion Criteria

Do NOT use P03.810 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 after delivery due to fetal heart rate abnormalities.

Documentation Requirements

Documentation must include details of the newborn's condition and any interventions performed.

Specialty Considerations

Neonatologists should ensure that all relevant details are captured to support the medical necessity of the evaluation.

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, including fetal heart rate abnormalities. This specificity aids in better tracking of outcomes and resource allocation in neonatal care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, including fetal heart rate abnormalities. This specificity aids in better tracking of outcomes and resource allocation in neonatal care.

Reimbursement & Billing Impact

reimbursement and quality reporting.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Coding for Newborns

Coding & Billing References

  • •
    American Academy of Pediatrics - Coding for Newborns

Frequently Asked Questions

What are the implications of coding P03.810 for newborn care?

Coding P03.810 indicates that the newborn was affected by fetal heart rate abnormalities prior to labor, which may necessitate specialized care and monitoring. Accurate coding ensures that the newborn's condition is recognized and managed appropriately, impacting both clinical outcomes and reimbursement.