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v1.0.0
ICD-10 Guide
ICD-10 CodesP05.2

P05.2

Billable

Newborn affected by fetal (intrauterine) malnutrition not light or small for gestational age

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

Code Description

ICD-10 P05.2 is a billable code used to indicate a diagnosis of newborn affected by fetal (intrauterine) malnutrition not light or small for gestational age.

Key Diagnostic Point:

P05.2 refers to newborns who are affected by fetal malnutrition due to various maternal factors, such as inadequate nutrition, placental insufficiency, or maternal health conditions, but who do not fall into the categories of being light or small for gestational age. This condition can arise from maternal factors including poor dietary intake, chronic diseases (like hypertension or diabetes), or substance abuse. The newborn may present with normal weight but exhibit signs of malnutrition such as poor feeding, lethargy, or developmental delays. Clinicians must assess the infant's growth parameters, feeding patterns, and overall health to determine the impact of intrauterine malnutrition. Proper documentation is essential to capture the nuances of the infant's condition and the maternal factors contributing to it.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between malnutrition and other growth-related issues.
  • Understanding maternal health conditions that contribute to fetal malnutrition.
  • Accurate assessment of newborn growth parameters.
  • Documentation of maternal history and its impact on the newborn's health.

Audit Risk Factors

  • Inadequate documentation of maternal health history.
  • Failure to specify the type of malnutrition.
  • Misclassification of the newborn's growth status.
  • Lack of clarity in the clinical notes regarding feeding issues.

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of the newborn's growth metrics, feeding patterns, and any interventions.

Common Clinical Scenarios

Newborns in the NICU with feeding difficulties or signs of developmental delays.

Billing Considerations

Ensure that maternal factors are well-documented to support the diagnosis.

Pediatrics

Documentation Requirements

Comprehensive pediatric assessments including growth monitoring and developmental milestones.

Common Clinical Scenarios

Follow-up visits for infants with a history of intrauterine malnutrition.

Billing Considerations

Consider the long-term implications of fetal malnutrition on pediatric health.

Coding Guidelines

Inclusion Criteria

Use P05.2 When
  • Follow the official ICD
  • CM guidelines for coding perinatal conditions, ensuring that all relevant maternal factors and newborn assessments are documented
  • Use growth charts to support coding decisions and ensure accurate representation of the newborn's condition

Exclusion Criteria

Do NOT use P05.2 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 when evaluating a newborn with suspected malnutrition.

Documentation Requirements

Document the newborn's weight, feeding patterns, and any interventions.

Specialty Considerations

Neonatologists should focus on growth metrics and 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, including P05.2, which helps in better tracking and management of fetal malnutrition cases.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, including P05.2, which helps in better tracking and management of fetal malnutrition cases.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, including P05.2, which helps in better tracking and management of fetal malnutrition cases.

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 indicators for coding P05.2?

Key indicators include normal weight for gestational age, signs of malnutrition such as poor feeding or lethargy, and a thorough maternal health history that indicates potential causes of fetal malnutrition.