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ICD-10 Guide
ICD-10 CodesP07.26

P07.26

Billable

Extreme immaturity of newborn, gestational age 27 completed weeks

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

Code Description

ICD-10 P07.26 is a billable code used to indicate a diagnosis of extreme immaturity of newborn, gestational age 27 completed weeks.

Key Diagnostic Point:

Extreme immaturity of newborn, classified under ICD-10 code P07.26, refers to infants born at a gestational age of 27 completed weeks or earlier. These newborns are at a significantly increased risk for a variety of complications due to their underdeveloped organ systems. Common issues include respiratory distress syndrome due to surfactant deficiency, intraventricular hemorrhage, and necrotizing enterocolitis. The management of these infants typically occurs in a Neonatal Intensive Care Unit (NICU), where they require specialized care, including thermal regulation, nutritional support, and monitoring for potential complications. Maternal factors such as preterm labor, infections, and placental insufficiency can contribute to extreme immaturity. Delivery complications, including emergency cesarean sections or prolonged labor, may also play a role in the outcomes for these infants. The prognosis for infants born at this gestational age varies widely, depending on the presence of associated conditions and the quality of neonatal care provided.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variability in clinical presentation and associated conditions
  • Need for detailed documentation of maternal and delivery complications
  • Potential for multiple co-morbidities requiring additional coding
  • Frequent updates to clinical guidelines and coding standards

Audit Risk Factors

  • Inadequate documentation of gestational age
  • Failure to capture associated conditions or complications
  • Misclassification of the severity of immaturity
  • Lack of clarity in maternal history and delivery details

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

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

Common Clinical Scenarios

Management of respiratory distress syndrome, monitoring for intraventricular hemorrhage, and nutritional support in the NICU.

Billing Considerations

Accurate coding requires understanding of the infant's clinical course and any interventions performed.

Pediatrics

Documentation Requirements

Comprehensive documentation of follow-up care, developmental assessments, and any ongoing complications.

Common Clinical Scenarios

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

Billing Considerations

Consideration of long-term outcomes and potential developmental delays associated with extreme prematurity.

Coding Guidelines

Inclusion Criteria

Use P07.26 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of gestational age and any associated conditions
  • Use additional codes to capture complications and co
  • morbidities as necessary

Exclusion Criteria

Do NOT use P07.26 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 in conjunction with P07.26 for initial assessment and management in the NICU.

Documentation Requirements

Document the infant's clinical status, gestational age, and any interventions performed.

Specialty Considerations

Neonatologists must ensure comprehensive documentation to support the complexity of care provided.

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 care for extremely immature infants. This specificity aids in better tracking of outcomes and resource utilization.

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 care for extremely immature infants. This specificity aids in better tracking of outcomes and resource utilization.

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 care for extremely immature infants. This specificity aids in better tracking of outcomes and resource utilization.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Neonatal Care

Coding & Billing References

  • •
    American Academy of Pediatrics - Neonatal Care

Frequently Asked Questions

What are the key factors to consider when coding for extreme immaturity?

Key factors include accurate documentation of gestational age, associated conditions, and maternal factors that may have contributed to preterm birth. It's essential to capture the complexity of care provided in the NICU and any follow-up care required.