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ICD-10 Guide
ICD-10 CodesP07.14

P07.14

Billable

Other low birth weight newborn, 1000-1249 grams

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

Code Description

ICD-10 P07.14 is a billable code used to indicate a diagnosis of other low birth weight newborn, 1000-1249 grams.

Key Diagnostic Point:

P07.14 refers to newborns who weigh between 1000 and 1249 grams at birth, categorized as other low birth weight newborns. This classification is crucial as low birth weight can be associated with various maternal factors such as preeclampsia, gestational diabetes, and inadequate prenatal care. Delivery complications, including preterm labor and placental insufficiency, can also contribute to low birth weight. Newborns in this weight category are at increased risk for complications such as respiratory distress syndrome, infections, and long-term developmental issues. Proper coding and documentation are essential to ensure appropriate care and resource allocation for these vulnerable infants. The management of these newborns often requires specialized neonatal care, including monitoring in a NICU setting, nutritional support, and interventions to address any immediate health concerns.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in maternal health conditions affecting birth weight
  • Need for detailed documentation of delivery complications
  • Differentiation from other low birth weight categories
  • Potential for multiple co-morbidities in low birth weight infants

Audit Risk Factors

  • Inadequate documentation of maternal health conditions
  • Failure to capture delivery complications
  • 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 or in the neonatal period.

Common Clinical Scenarios

Management of a preterm infant weighing 1100 grams with respiratory distress and feeding intolerance.

Billing Considerations

Ensure accurate tracking of growth parameters and developmental milestones for follow-up care.

Pediatrics

Documentation Requirements

Comprehensive history of maternal health, delivery details, and ongoing assessments of the infant's health.

Common Clinical Scenarios

Follow-up of a low birth weight infant with potential developmental delays or chronic health issues.

Billing Considerations

Consider the long-term implications of low birth weight on pediatric health and development.

Coding Guidelines

Inclusion Criteria

Use P07.14 When
  • Follow the official ICD
  • CM guidelines for coding low birth weight, ensuring accurate documentation of birth weight, gestational age, and any associated maternal or delivery complications

Exclusion Criteria

Do NOT use P07.14 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 assessment of a low birth weight newborn in the NICU.

Documentation Requirements

Document birth weight, gestational age, and any immediate health concerns.

Specialty Considerations

Neonatologists should ensure comprehensive evaluations are performed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of low birth weight categories, improving the ability to track and manage neonatal outcomes. This specificity aids in research and quality improvement initiatives in neonatal care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of low birth weight categories, improving the ability to track and manage neonatal outcomes. This specificity aids in research and quality improvement initiatives in neonatal care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of low birth weight categories, improving the ability to track and manage neonatal outcomes. This specificity aids in research and quality improvement initiatives in neonatal care.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Neonatal Care Guidelines

Coding & Billing References

  • •
    American Academy of Pediatrics - Neonatal Care Guidelines

Frequently Asked Questions

What are the key factors to document for coding P07.14?

Key factors include the infant's birth weight, gestational age, any maternal health conditions that contributed to low birth weight, and details of any delivery complications. Comprehensive documentation ensures accurate coding and appropriate care.