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ICD-10 Guide
ICD-10 CodesP07.34

P07.34

Billable

Preterm newborn, gestational age 31 completed weeks

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

Code Description

ICD-10 P07.34 is a billable code used to indicate a diagnosis of preterm newborn, gestational age 31 completed weeks.

Key Diagnostic Point:

P07.34 refers to a preterm newborn who has been delivered at 31 completed weeks of gestation. This classification is crucial as it highlights the infant's increased risk for various complications associated with prematurity, including respiratory distress syndrome, intraventricular hemorrhage, and feeding difficulties. Newborns at this gestational age may require specialized care in a Neonatal Intensive Care Unit (NICU) due to their underdeveloped organs and systems. Maternal factors such as hypertension, diabetes, or infections can contribute to preterm delivery, and understanding these factors is essential for comprehensive care. Delivery complications, including placental abruption or preterm premature rupture of membranes (PPROM), can also play a significant role in the infant's health outcomes. Close monitoring and intervention are often necessary to manage the potential complications that arise in this vulnerable population, making accurate coding essential for appropriate resource allocation and care planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation of preterm infants
  • Need for detailed maternal history and delivery complications
  • Potential for multiple co-morbidities requiring additional coding
  • Documentation requirements for NICU care

Audit Risk Factors

  • Inadequate documentation of gestational age
  • Failure to capture maternal health conditions
  • Misclassification of delivery complications
  • Inconsistent coding of associated neonatal conditions

Specialty Focus

Medical Specialties

Neonatology

Documentation Requirements

Detailed records of gestational age, birth weight, and any immediate complications post-delivery.

Common Clinical Scenarios

Management of respiratory distress syndrome, feeding intolerance, and temperature regulation in the NICU.

Billing Considerations

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

Pediatrics

Documentation Requirements

Comprehensive history of maternal health, delivery complications, and ongoing developmental assessments.

Common Clinical Scenarios

Follow-up care for preterm infants, including growth monitoring and developmental screenings.

Billing Considerations

Pediatricians must be aware of long-term outcomes associated with prematurity and document accordingly.

Coding Guidelines

Inclusion Criteria

Use P07.34 When
  • According to ICD
  • 10 guidelines, accurate coding for P07
  • 34 requires documentation of gestational age, birth weight, and any associated maternal or delivery complications
  • Coders should ensure that all relevant clinical information is captured to support the diagnosis

Exclusion Criteria

Do NOT use P07.34 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 evaluation of a preterm infant in the NICU.

Documentation Requirements

Document gestational age, weight, and any immediate complications.

Specialty Considerations

Neonatologists should ensure thorough documentation of the infant's clinical status.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of preterm conditions, improving the ability to track outcomes and resource utilization for preterm infants.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of preterm conditions, improving the ability to track outcomes and resource utilization for preterm infants.

Reimbursement & Billing Impact

reimbursement and resource allocation.

Resources

Clinical References

  • •
    American Academy of Pediatrics - Guidelines for Coding in Neonatology

Coding & Billing References

  • •
    American Academy of Pediatrics - Guidelines for Coding in Neonatology

Frequently Asked Questions

What are the key factors to document for coding P07.34?

Key factors include the infant's gestational age, birth weight, any maternal health issues, delivery complications, and immediate postnatal care needs.