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ICD-10 Guide
ICD-10 CodesP07.20

P07.20

Billable

Extreme immaturity of newborn, unspecified weeks of gestation

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

Code Description

ICD-10 P07.20 is a billable code used to indicate a diagnosis of extreme immaturity of newborn, unspecified weeks of gestation.

Key Diagnostic Point:

Extreme immaturity of a newborn refers to infants born at less than 28 weeks of gestation. These infants are at a significantly higher risk for various complications due to their underdeveloped organ systems. Common issues include respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis. The management of these infants typically occurs in a Neonatal Intensive Care Unit (NICU), where they receive specialized care including respiratory support, temperature regulation, and nutritional support. Maternal factors such as preeclampsia, infections, or substance abuse can contribute to extreme prematurity. Delivery complications, including placental abruption or previa, can also lead to early delivery. Accurate coding of this condition is crucial for appropriate treatment planning and resource allocation in neonatal care.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in gestational age determination
  • Multiple potential maternal factors influencing prematurity
  • Complexity of associated neonatal conditions
  • Need for precise documentation of delivery complications

Audit Risk Factors

  • Inadequate documentation of gestational age
  • Failure to link maternal conditions to newborn outcomes
  • Misclassification of the severity of immaturity
  • Inconsistent coding of associated complications

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of gestational age, birth weight, and clinical interventions are essential.

Common Clinical Scenarios

Infants requiring mechanical ventilation, those with feeding intolerance, or presenting with signs of infection.

Billing Considerations

Documentation must reflect the severity of immaturity and any associated complications to support coding.

Pediatrics

Documentation Requirements

Pediatricians should document follow-up care, developmental assessments, and any ongoing complications.

Common Clinical Scenarios

Pediatric evaluations of growth and development in infants with a history of extreme prematurity.

Billing Considerations

Consideration of long-term outcomes and potential developmental delays is crucial for accurate coding.

Coding Guidelines

Inclusion Criteria

Use P07.20 When
  • Follow the ICD
  • CM guidelines for coding perinatal conditions, ensuring accurate documentation of gestational age and associated maternal factors

Exclusion Criteria

Do NOT use P07.20 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 newborn with extreme immaturity.

Documentation Requirements

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

Specialty Considerations

Neonatologists should ensure detailed documentation of the infant's condition 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, improving the ability to capture the complexity of cases like extreme immaturity.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, improving the ability to capture the complexity of cases like extreme immaturity.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of perinatal conditions, improving the ability to capture the complexity of cases like extreme immaturity.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Neonatal Coding Guidelines

Coding & Billing References

  • •
    American Academy of Pediatrics - Neonatal Coding Guidelines

Frequently Asked Questions

What documentation is necessary to support the use of code P07.20?

Documentation must include gestational age, birth weight, clinical presentation, and any maternal factors contributing to the infant's condition. Detailed notes on the management and interventions provided in the NICU are also essential.