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ICD-10 Guide
ICD-10 CodesP07.36

P07.36

Billable

Preterm newborn, gestational age 33 completed weeks

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

Code Description

ICD-10 P07.36 is a billable code used to indicate a diagnosis of preterm newborn, gestational age 33 completed weeks.

Key Diagnostic Point:

P07.36 refers to a preterm newborn who has reached a gestational age of 33 completed weeks. This classification is crucial in neonatology as it helps healthcare providers identify infants who may be at risk for various complications associated with prematurity. Newborns at this gestational age are typically classified as moderate preterm and may exhibit a range of health issues, including respiratory distress syndrome, feeding difficulties, and temperature regulation challenges. Maternal factors such as hypertension, diabetes, or infections can contribute to preterm birth, necessitating close monitoring and specialized care. Delivery complications, including placental abruption or previa, can also lead to preterm delivery, impacting the newborn's health outcomes. Understanding the implications of this code is essential for accurate documentation, appropriate care planning, and resource allocation in neonatal intensive care units (NICUs).

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation among preterm infants
  • Need for detailed maternal history to assess risk factors
  • Potential for multiple co-morbidities requiring additional coding
  • Differentiation from other gestational age codes

Audit Risk Factors

  • Inadequate documentation of maternal health conditions
  • Failure to document delivery complications
  • Incorrect assignment of gestational age
  • Omission of co-morbid conditions

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

Infants requiring respiratory support, IV nutrition, or phototherapy due to jaundice.

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 details, and ongoing developmental assessments.

Common Clinical Scenarios

Follow-up visits for growth monitoring and developmental milestones in preterm infants.

Billing Considerations

Pediatricians must be aware of the long-term implications of prematurity on health outcomes.

Coding Guidelines

Inclusion Criteria

Use P07.36 When
  • Follow the ICD
  • CM guidelines for coding perinatal conditions, ensuring accurate documentation of gestational age and any associated maternal factors
  • Use additional codes to capture complications and co
  • morbidities

Exclusion Criteria

Do NOT use P07.36 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99460CPT Code

Initial hospital care, newborn

Clinical Scenario

Used for the initial evaluation of a preterm infant in the NICU.

Documentation Requirements

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

Specialty Considerations

Neonatologists must ensure accurate coding based on 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 in neonatal care.

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 in neonatal care.

Reimbursement & Billing Impact

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

Resources

Clinical References

  • •
    American Academy of Pediatrics - Neonatal Coding Guidelines

Coding & Billing References

  • •
    American Academy of Pediatrics - Neonatal Coding Guidelines

Frequently Asked Questions

What are the key factors to consider when coding for a preterm newborn?

Key factors include accurate documentation of gestational age, maternal health conditions, delivery complications, and any co-morbidities present at birth. It is essential to differentiate between various gestational ages and to ensure that all relevant conditions are coded appropriately.