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ICD-10 Guide
ICD-10 CodesP07.00

P07.00

Billable

Extremely low birth weight newborn, unspecified weight

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

Code Description

ICD-10 P07.00 is a billable code used to indicate a diagnosis of extremely low birth weight newborn, unspecified weight.

Key Diagnostic Point:

Extremely low birth weight (ELBW) newborns are defined as infants born weighing less than 1000 grams (2 lbs 3 oz) at birth. This condition is often associated with significant perinatal complications, including respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis. ELBW infants are at a higher risk for long-term developmental issues and require specialized neonatal care. Factors contributing to ELBW include maternal conditions such as preeclampsia, gestational diabetes, and infections, as well as complications during delivery like preterm labor and placental insufficiency. The management of ELBW newborns typically occurs in a Neonatal Intensive Care Unit (NICU), where they receive comprehensive monitoring and interventions to support their growth and development. Accurate coding for ELBW is crucial for appropriate reimbursement and resource allocation in neonatal care.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in birth weight reporting and classification
  • Need for detailed maternal history and delivery complications
  • Potential for multiple co-morbid conditions requiring additional coding
  • Documentation requirements for NICU care and interventions

Audit Risk Factors

  • Inadequate documentation of birth weight and gestational age
  • Failure to capture maternal risk factors and complications
  • Misclassification of birth weight categories
  • Lack of clarity in NICU care documentation

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of birth weight, gestational age, and any complications during delivery. Documentation of NICU interventions and outcomes is essential.

Common Clinical Scenarios

Management of ELBW infants with respiratory distress, feeding intolerance, and temperature instability in the NICU.

Billing Considerations

Coders must be aware of the specific interventions and monitoring protocols used in the NICU to accurately reflect the complexity of care provided.

Pediatrics

Documentation Requirements

Documentation of follow-up care, developmental assessments, and any ongoing health issues related to being an ELBW infant.

Common Clinical Scenarios

Pediatric follow-up visits for ELBW infants focusing on growth, neurodevelopmental outcomes, and management of chronic conditions.

Billing Considerations

Pediatric coders should be familiar with the long-term implications of ELBW and the associated conditions that may arise.

Coding Guidelines

Inclusion Criteria

Use P07.00 When
  • Coders should refer to the official ICD
  • CM guidelines for perinatal coding, ensuring accurate documentation of birth weight, gestational age, and any maternal factors or delivery complications that may impact the newborn's health

Exclusion Criteria

Do NOT use P07.00 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 infant

Clinical Scenario

Used for initial evaluation of an ELBW infant in the NICU.

Documentation Requirements

Documentation of the infant's condition, weight, and any interventions performed.

Specialty Considerations

Neonatologists should ensure detailed notes on the infant's status and care plan.

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 ELBW, which helps in capturing the complexity of care and improving reimbursement accuracy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, including ELBW, which helps in capturing the complexity of care and improving reimbursement accuracy.

Reimbursement & Billing Impact

reimbursement accuracy.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Neonatal Care Guidelines

Coding & Billing References

  • •
    American Academy of Pediatrics - Neonatal Care Guidelines

Frequently Asked Questions

What is the significance of coding P07.00?

Coding P07.00 is crucial for identifying extremely low birth weight infants, which helps in tracking outcomes and resource allocation in neonatal care. Accurate coding ensures that healthcare providers receive appropriate reimbursement for the specialized care required for these vulnerable infants.