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v1.0.0
ICD-10 Guide
ICD-10 CodesP03.811

P03.811

Billable

Newborn affected by abnormality in fetal (intrauterine) heart rate or rhythm during labor

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

Code Description

ICD-10 P03.811 is a billable code used to indicate a diagnosis of newborn affected by abnormality in fetal (intrauterine) heart rate or rhythm during labor.

Key Diagnostic Point:

This code is used to classify newborns who exhibit abnormalities in heart rate or rhythm that occur during labor, which can be influenced by various complications such as breech delivery, forceps delivery, or cesarean delivery. These abnormalities may manifest as tachycardia, bradycardia, or irregular rhythms, potentially leading to adverse outcomes if not monitored and managed appropriately. The underlying causes can include fetal distress due to umbilical cord compression, maternal factors, or complications arising from the delivery method. Accurate coding is essential for tracking the incidence of these conditions and ensuring appropriate care and follow-up for affected newborns.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in fetal heart rate patterns and their clinical significance
  • Differentiation between transient and persistent abnormalities
  • Documentation of delivery method and its impact on fetal heart rate
  • Need for comprehensive maternal and neonatal history

Audit Risk Factors

  • Inadequate documentation of fetal heart rate monitoring
  • Failure to link abnormal heart rate to specific delivery complications
  • Misclassification of transient vs. persistent abnormalities
  • Lack of clarity in maternal history impacting fetal heart rate

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of fetal heart rate monitoring, delivery complications, and immediate neonatal assessment.

Common Clinical Scenarios

Newborns presenting with respiratory distress or altered vital signs following a complicated delivery.

Billing Considerations

Ensure that all relevant maternal and delivery details are documented to support the coding of P03.811.

Pediatrics

Documentation Requirements

Comprehensive follow-up notes on the newborn's heart rate and rhythm abnormalities.

Common Clinical Scenarios

Pediatric evaluations of newborns with a history of fetal heart rate abnormalities during labor.

Billing Considerations

Consider the long-term implications of fetal heart rate abnormalities on pediatric health.

Coding Guidelines

Inclusion Criteria

Use P03.811 When
  • Follow the official ICD
  • CM guidelines for coding perinatal conditions, ensuring that all relevant clinical information is documented
  • Specific criteria for fetal heart rate abnormalities must be met, including the duration and nature of the abnormality

Exclusion Criteria

Do NOT use P03.811 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 in conjunction with P03.811 when monitoring newborns with heart rate abnormalities.

Documentation Requirements

Document the evaluation of the newborn's heart rate and any interventions performed.

Specialty Considerations

Neonatologists should ensure thorough documentation of all assessments and interventions.

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 track and manage complications related to fetal heart rate abnormalities during labor.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, improving the ability to track and manage complications related to fetal heart rate abnormalities during labor.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, improving the ability to track and manage complications related to fetal heart rate abnormalities during labor.

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 factors to consider when coding P03.811?

Key factors include the delivery method, the nature of the fetal heart rate abnormality, and comprehensive documentation of maternal and neonatal history.