ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesP05.06

P05.06

Billable

Newborn light for gestational age, 1500-1749 grams

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

Code Description

ICD-10 P05.06 is a billable code used to indicate a diagnosis of newborn light for gestational age, 1500-1749 grams.

Key Diagnostic Point:

P05.06 refers to newborns who are classified as light for gestational age, specifically those weighing between 1500 and 1749 grams at birth. This condition is often associated with various maternal factors such as inadequate prenatal care, maternal smoking, substance abuse, and chronic health conditions like hypertension or diabetes. Delivery complications, including preterm labor and placental insufficiency, can also contribute to low birth weight. Newborns in this category are at increased risk for a range of health issues, including respiratory distress syndrome, hypoglycemia, and difficulties with thermoregulation. Close monitoring and specialized care in a neonatal intensive care unit (NICU) are often required to address these risks and support the infant's growth and development. Accurate coding of this condition is crucial for appropriate management and resource allocation in neonatal care.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in maternal health conditions affecting birth weight
  • Differentiation between preterm and term infants
  • Need for detailed documentation of delivery complications
  • Potential for co-morbid conditions requiring additional coding

Audit Risk Factors

  • Inadequate documentation of maternal health history
  • Failure to specify gestational age accurately
  • Misclassification of birth weight categories
  • Lack of follow-up documentation for neonatal outcomes

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of birth weight, gestational age, and any complications during delivery.

Common Clinical Scenarios

Infants admitted to the NICU for respiratory support or feeding difficulties due to low birth weight.

Billing Considerations

Ensure accurate tracking of growth parameters and developmental milestones during hospitalization.

Pediatrics

Documentation Requirements

Comprehensive pediatric assessments including growth charts and developmental screenings.

Common Clinical Scenarios

Follow-up visits for infants with low birth weight to monitor growth and development.

Billing Considerations

Consider the long-term implications of low birth weight on health outcomes.

Coding Guidelines

Inclusion Criteria

Use P05.06 When
  • Follow the official ICD
  • CM guidelines for coding perinatal conditions, ensuring accurate documentation of gestational age and birth weight
  • Use additional codes for any associated complications or co
  • morbidities

Exclusion Criteria

Do NOT use P05.06 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 initial assessments of newborns classified as light for gestational age.

Documentation Requirements

Document birth weight, gestational age, and any immediate complications.

Specialty Considerations

Neonatologists should ensure comprehensive evaluations are documented.

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 data collection and reimbursement processes for low birth weight infants.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, improving the accuracy of data collection and reimbursement processes for low birth weight infants.

Reimbursement & Billing Impact

reimbursement processes for low birth weight infants.

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 factors contribute to a newborn being classified as light for gestational age?

Factors include maternal health issues such as hypertension, diabetes, inadequate prenatal care, smoking, and substance abuse, as well as complications during pregnancy and delivery.